Study Reveals Need for Standardizing Expert Opinion in Guidelines

In a methodological study published in BMC Medical Research Methodology, experts delved into the intricate world of clinical guidelines, aiming to shed light on the use of Expert Opinion (EO) by 98 scientific societies. The study revealed a lack of standardization and a clear definition of EO, prompting the need for a comprehensive understanding of its application in guideline development.

Clinical guidelines play a crucial role in healthcare, providing essential guidance to clinicians. However, the variable use of EO in these guidelines has been a point of contention. Despite improvements in guideline quality, the incorporation of EO remains ambiguous, especially in the absence of high-quality evidence.

The study systematically analyzed methodological manuals from various societies to unravel the complexities surrounding EO. It identified 473 national and international societies, with 98 manuals scrutinized for insights into EO. The findings highlighted the prevalent use of EO, with 66% of manuals mentioning its utilization.

Among the societies that incorporated EO, two main themes emerged: filling evidence gaps and interpreting existing evidence. EO was often employed when robust data was lacking, allowing guideline developers to offer recommendations based on expert insights. The study identified five primary foundations for EO, including clinical experience, indirect evidence, low-quality evidence, mechanism-based reasoning, and expert evidence/testimony.

The study proposed a comprehensive definition of EO to encapsulate its multifaceted nature, emphasizing its role in supporting clinical decision-making in the absence of evidence or when existing evidence requires interpretation. The researchers advocated for a harmonized framework to standardize the application of EO in guidelines, emphasizing the need for transparency and consistency.

By bridging the gap between contrasting perspectives on EO and offering a data-driven definition, the study laid the groundwork for future standardization frameworks. The proposed definition serves as a stepping stone towards enhancing guideline consistency, transparency, and clinical decision-making.

The findings underscored the importance of EO in addressing evidence gaps and interpreting ambiguous evidence, emphasizing the need for standardization to ensure guideline quality and reliability. The study’s insights provide a valuable foundation for developing clearer methodological guidance in guideline development, aiming to improve the integrity and applicability of clinical guidelines.