Scholarlink

Background <p>The use of Expert Opinion (EO) in clinical guidelines is highly variable and lacks standardization, leading to ongoing controversy. A clear and universally accepted definition of EO is also lacking. To date, no research has systematically assessed how guideline-developing societies conceptualize and apply EO. This study aims to map methodological manuals, evaluate their rationale for EO use, examine its foundations, and synthesize a comprehensive definition.</p> Methods <p>Systematic searches for clinical guidelines were conducted in PubMed to identify guideline-developing societies, supplemented by additional searches. Systematic searches were then conducted to identify methodological manuals from these societies. Screening was performed independently by two reviewers, and data extraction was conducted using piloted forms. Findings were summarized through narrative evidence synthesis using descriptive statistics.</p> Results <p>A total of 473 national and international societies were identified, and methodological manuals from 98 societies were mapped and analysed. These manuals included 61 handbooks, 29 journal articles, and 8 websites. EO is mentioned in 65 (66%) manuals, with substantial variation in its utilization and terminology. EO is primarily used in two contexts: (1) filling evidence gaps (72%), and (2) interpreting existing evidence (8%). In the remaining 20%, EO use is unclear. Five main foundations could be identified as a potential basis for EO (clinical experience, indirect evidence, low-quality evidence, mechanism-based reasoning, and expert evidence/witnesses). Based on these findings, a novel comprehensive definition of EO was synthesized.</p> Conclusions <p>EO is widely used to address evidence gaps and interpret ambiguous evidence, underscoring its importance in guideline development. However, the variability in its application and conceptualization across societies highlights the need for standardization. We propose a comprehensive EO definition as a first step towards standardization to improve consistency, transparency, and clinical decision-making.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Defining expert opinion in clinical guidelines: insights from 98 scientific societies – a methodological study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年4月2日

查看全文
  • Blin Nagavci,
  • Zsófia Gáspár,
  • Botond Lakatos

摘要

Background

The use of Expert Opinion (EO) in clinical guidelines is highly variable and lacks standardization, leading to ongoing controversy. A clear and universally accepted definition of EO is also lacking. To date, no research has systematically assessed how guideline-developing societies conceptualize and apply EO. This study aims to map methodological manuals, evaluate their rationale for EO use, examine its foundations, and synthesize a comprehensive definition.

Methods

Systematic searches for clinical guidelines were conducted in PubMed to identify guideline-developing societies, supplemented by additional searches. Systematic searches were then conducted to identify methodological manuals from these societies. Screening was performed independently by two reviewers, and data extraction was conducted using piloted forms. Findings were summarized through narrative evidence synthesis using descriptive statistics.

Results

A total of 473 national and international societies were identified, and methodological manuals from 98 societies were mapped and analysed. These manuals included 61 handbooks, 29 journal articles, and 8 websites. EO is mentioned in 65 (66%) manuals, with substantial variation in its utilization and terminology. EO is primarily used in two contexts: (1) filling evidence gaps (72%), and (2) interpreting existing evidence (8%). In the remaining 20%, EO use is unclear. Five main foundations could be identified as a potential basis for EO (clinical experience, indirect evidence, low-quality evidence, mechanism-based reasoning, and expert evidence/witnesses). Based on these findings, a novel comprehensive definition of EO was synthesized.

Conclusions

EO is widely used to address evidence gaps and interpret ambiguous evidence, underscoring its importance in guideline development. However, the variability in its application and conceptualization across societies highlights the need for standardization. We propose a comprehensive EO definition as a first step towards standardization to improve consistency, transparency, and clinical decision-making.