PERCEPTION AND KNOWLEDGE OF PEDIATRIC NEPHROLOGISTS ON EVIDENCE-BASED GUIDELINE DEVELOPMENT METHODOLOGY

Dear Colleagues,

In our clinical practice, we get benefits from guideline documents. The strength of recommendations and the quality of evidence of guidelines require rigorous evaluation. In this survey, we aimed to evaluate the perception and knowledge of pediatric nephrologists on evidence-based guideline development methodology. Your contribution is of particular value.

Thank you for your participation.

Sevcan A. Bakkaloglu

Pankaj Hari

Olivia Boyer

Franz Schaefer

Question Title

* 1. How many years have you been practicing in pediatric nephrology?

1-3

>3-10

>10-20

>20

Question Title

* 2. What is your current position?

Consultant/Faculty in pediatric nephrology in an academic center (active in ped neph fellow training)

Pediatric nephrologist in a center/office not giving ped neph fellow training

Pediatric nephrology trainee in an academic center

Question Title

* 3. How often do you use guidelines in your daily pediatric nephrology practice?

Everyday

Once/twice in a week

Once/twice in a month

Rarely

Never

Question Title

* 4. How helpful do you find evidence-based guidelines to guide your clinical decision-making?

Very helpful

Quite helpful

Sometimes helpful

Rarely helpful

Not helpful

Question Title

* 5. How helpful do you find clinical practice points or consensus papers to guide your clinical decision-making?

Very helpful

Quite helpful

Sometimes helpful

Rarely helpful

Not helpful

Question Title

* 6. Which of the followings are important factors for you to rely on a guideline? (please rank them, 1: most important)

Question Title

* 7. Which guidelines do you use most frequently? - (up to 3 choices are acceptable)

ESPN Working Group Guidelines

ERKNet Guidelines

IPNA Guidelines

KDOQI Guidelines

KDIGO Guidelines

ISPD Guidelines

National Society Guidelines

Cochrane reviews

Other (please specify)

Question Title

* 8. Which single guideline have you been using most frequently in the past 2-3 years?

Please give in detail (Author, Journal name and year, guideline name)

Question Title

* 9. Which part(s) of a guideline document do you read in general?

Only abstract/plain summary

Only statements

Methodology (method of guideline development)

Statements and rationales/background

Statements and summary of findings tables

Summary of findings tables

Outcome figures

Whole document

Question Title

* 10. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach has been developed to facilitate the rigorous and transparent formulation of recommendations from evidence. How knowledgeable are you about the elements of GRADE methodology?

Formally trained

Quite knowledgable

Limited knowledge

Not knowledgeable

Question Title

* 11. How important is asking right questions that include all patient- important and critical outcomes (PICO: Population, Intervention, Comparison, Outcome) in the development of a trustworthy clinical guidelines?

Fundamental

Important

Arbitrary

Question Title

* 12. Do systematic literature review, data extraction and evidence assessment require a formal training?

Yes

Question Title

* 13. Do you take into acoount risk of bias assessment?

Yes

Question Title

* 14. Do you know how hazard graphics are prepared?

Yes

Question Title

* 15. Do you know how to assess the methodological limitations of randomized and non-randomized trials (observational evidence)?

Yes

Question Title

* 16. Do you know how to assess certainty of overall evidence?

Yes

Question Title

* 17. Which of the main domains used to assess the certainty of the evidence are most important?

Risk of bias

Inconsistency

Indirectness of evidence

Imprecision

Publication bias

Question Title

* 18. What is your general opinion about the rating of certainty of evidence in pediatric nephrology guidelines?

High

Moderate

Low

Very low

Question Title

* 19. How strongly do you agree with the statement “The risk of bias assessment is largely ignored in many guidance papers based on expert opinion.” ?

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

Question Title

* 20. What is your general opinion about pediatric nephrology guidelines?

They typically present;

Enough evidence, strong recommendations

Limited evidence, conditional recommendations

Limited evidence, ungraded recommendations/expert opinions

Question Title

* 21. What is your general opinion about the source of pediatric nephrology guidelines?

Mainly based on extrapolation of adult data

Mainly based on limited evidence based pediatric data

Mainly based on opinion based pediatric data

Question Title

* 22. Do you think that ungraded best or good practice statements (GPS) can be considered trustworthy clinical guidelines?

Yes, whenever enough evidence is not available

No, it is better to make no statement when there is no evidence

Other (please specify)

Question Title

* 23. How commonly do guidelines make changes to your daily practice regarding particular clinical problems?

Mutiple times

Quite often

Perhaps a few times

Never

Question Title

* 24. Have you been involved in a published guideline development?

Yes, in 1-2 projects

Yes, in 3-4 projects

Yes, in 5 or more projects

Question Title

* 25. If yes, how long did it take from workgroup formation to publication of the guideline? (if many times, please consider the first one)

6 months

7-12 months

1-2 years

>2 years

Question Title

* 26. Would you like to be involved as an expert in a guideline development project?

Yes, definitely

Maybe

Question Title

* 27. Have you ever been formally trained for evidence development and implementation?

Yes

Question Title

* 28. If yes, please specify the name of the institution/organization where you were trained?

Question Title

* 29. If no, would you be interested in a training on evidence development and implementation?

Yes, definitely

Maybe

Question Title

* 30. What do you think about a new terminology as “Clinical Practice Guideline Literacy”?

Good, informative

Intriguing

Bizzare, unnecessary

No idea

PERCEPTION AND KNOWLEDGE OF PEDIATRIC NEPHROLOGISTS ON EVIDENCE-BASED GUIDELINE DEVELOPMENT METHODOLOGY

Question Title

* 1. How many years have you been practicing in pediatric nephrology?

Question Title

* 2. What is your current position?

Question Title

* 3. How often do you use guidelines in your daily pediatric nephrology practice?

Question Title

* 4. How helpful do you find evidence-based guidelines to guide your clinical decision-making?

Question Title

* 5. How helpful do you find clinical practice points or consensus papers to guide your clinical decision-making?

Question Title

* 6. Which of the followings are important factors for you to rely on a guideline? (please rank them, 1: most important)

Question Title

* 7. Which guidelines do you use most frequently? - (up to 3 choices are acceptable)

Question Title

* 8. Which single guideline have you been using most frequently in the past 2-3 years?Please give in detail (Author, Journal name and year, guideline name)

Question Title

* 9. Which part(s) of a guideline document do you read in general?

Question Title

* 10. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach has been developed to facilitate the rigorous and transparent formulation of recommendations from evidence. How knowledgeable are you about the elements of GRADE methodology?

Question Title

* 11. How important is asking right questions that include all patient- important and critical outcomes (PICO: Population, Intervention, Comparison, Outcome) in the development of a trustworthy clinical guidelines?

Question Title

* 12. Do systematic literature review, data extraction and evidence assessment require a formal training?

Question Title

* 13. Do you take into acoount risk of bias assessment?

Question Title

* 14. Do you know how hazard graphics are prepared?

Question Title

* 15. Do you know how to assess the methodological limitations of randomized and non-randomized trials (observational evidence)?

Question Title

* 16. Do you know how to assess certainty of overall evidence?

Question Title

* 17. Which of the main domains used to assess the certainty of the evidence are most important?

Question Title

* 18. What is your general opinion about the rating of certainty of evidence in pediatric nephrology guidelines?

Question Title

* 19. How strongly do you agree with the statement “The risk of bias assessment is largely ignored in many guidance papers based on expert opinion.” ?

Question Title

* 20. What is your general opinion about pediatric nephrology guidelines? They typically present;

Question Title

* 21. What is your general opinion about the source of pediatric nephrology guidelines?

Question Title

* 22. Do you think that ungraded best or good practice statements (GPS) can be considered trustworthy clinical guidelines?

Question Title

* 23. How commonly do guidelines make changes to your daily practice regarding particular clinical problems?

Question Title

* 24. Have you been involved in a published guideline development?

Question Title

* 25. If yes, how long did it take from workgroup formation to publication of the guideline? (if many times, please consider the first one)

Question Title

* 26. Would you like to be involved as an expert in a guideline development project?

Question Title

* 27. Have you ever been formally trained for evidence development and implementation?

Question Title

* 28. If yes, please specify the name of the institution/organization where you were trained?

Question Title

* 29. If no, would you be interested in a training on evidence development and implementation?

Question Title

* 30. What do you think about a new terminology as “Clinical Practice Guideline Literacy”?

* 8. Which single guideline have you been using most frequently in the past 2-3 years?

Please give in detail (Author, Journal name and year, guideline name)

* 20. What is your general opinion about pediatric nephrology guidelines?

They typically present;