Compromiso por la calidad de las sociedades científicas en España / Commitment to quality of the Spanish scientific societies

En este artículo se resumen los objetivos, la metodología y las primeras conclusiones del proyecto «Compromiso por la calidad de las sociedades científicas en España», coordinado por el Ministerio de Sanidad, Servicios Sociales e Igualdad, la Sociedad Española de Medicina Interna y el Instituto Aragonés de Ciencias de la Salud, en el que participan 48 sociedades científicas. Los objetivos de este proyecto son: disminuir la utilización de intervenciones médicas innecesarias, que son las que no han demostrado eficacia, tienen escasa o dudosa efectividad, o no son coste-efectivas; disminuir la variabilidad en la práctica clínica; difundir entre médicos y pacientes el compromiso con el uso adecuado de recursos sanitarios y, por último, promover la seguridad clínica. En el documento se incluyen 135 recomendaciones finales de «no hacer» elaboradas por 30 sociedades científicas españolas (AU)

This article summarises the objectives, methodology and initial conclusions of the project «Commitment to Quality of the Spanish Scientific Societies», coordinated by the Ministry of Health, Social Services and Equality, the Spanish Society of Internal Medicine and the Aragon Institute of Health Sciences, in which 48 scientific societies participate. This project's objectives are to decrease the use of unnecessary medical interventions, which are those that have shown no efficacy, have little or questionable effectiveness or are not cost-effective; decrease variability in clinical practice; promote the commitment among physicians and patients to properly use healthcare resources; and to promote clinical safety. The document includes 135 final recommendations for what not to do, prepared by 30 Spanish scientific societies (AU)

Commitment to quality of the Spanish scientific societies. / Compromiso por la calidad de las sociedades científicas en España.

This article summarises the objectives, methodology and initial conclusions of the project "Commitment to Quality of the Spanish Scientific Societies", coordinated by the Ministry of Health, Social Services and Equality, the Spanish Society of Internal Medicine and the Aragon Institute of Health Sciences, in which 48 scientific societies participate. This project's objectives are to decrease the use of unnecessary medical interventions, which are those that have shown no efficacy, have little or questionable effectiveness or are not cost-effective; decrease variability in clinical practice; promote the commitment among physicians and patients to properly use healthcare resources; and to promote clinical safety. The document includes 135 final recommendations for what not to do, prepared by 30 Spanish scientific societies.

Efficiency of pragmatic search strategies to update clinical guidelines recommendations.

BACKGROUND: A major challenge in updating clinical guidelines is to efficiently identify new, relevant evidence. We evaluated the efficiency and feasibility of two new approaches: the development of restrictive search strategies using PubMed Clinical Queries for MEDLINE and the use of the PLUS (McMaster Premium Literature Service) database. METHODS: We evaluated a random sample of recommendations from a national guideline development program and identified the references that would potentially trigger an update (key references) using an exhaustive approach. We designed restrictive search strategies using the minimum number of Medical Subject Headings (MeSH) terms and text words required from the original exhaustive search strategies and applying broad and narrow filters. We developed PLUS search strategies, matching Medical Subject Headings (MeSH) and Systematized Nomenclature of Medicine (SNOMED) terms with guideline topics. We compared the number of key references retrieved by these approaches with those retrieved by the exhaustive approach. RESULTS: The restrictive approach retrieved 68.1 % fewer references than the exhaustive approach (12,486 versus 39,136), and identified 89.9 % (62/69) of key references and 88 % (22/25) of recommendation updates. The use of PLUS retrieved 88.5 % fewer references than the exhaustive approach (4,486 versus 39,136) and identified substantially fewer key references (18/69, 26.1 %) and fewer recommendation updates (10/25, 40 %). CONCLUSIONS: The proposed restrictive approach is a highly efficient and feasible method to identify new evidence that triggers a recommendation update. Searching only in the PLUS database proved to be a suboptimal approach and suggests the need for topic-specific tailoring.