Projects


Guideline Standardization
COGS
Conference on Guideline Standardization
Definition of the key elements to include in clinical guidelines; promotion of guideline quality and support for implementation.
keywords Main objective
Evidence-based clinical practice guidelines, guideline development, dissemination, implementation, standardization, components.

"To "define a standard for guideline reporting that would promote guideline quality and facilitate implementation" (Shiffman).
summary
The COGS checklist, a consolidated list of 18 topics seen as necessary components of practice guidelines, is as follows [from Shiffman et al, 2003, which includes fuller explanations]:
  1. Overview material - abstract, date etc.
  2. Focus
  3. Goal
  4. Users / setting
  5. Target population
  6. Developer
  7. Funding source / sponsor
  8. Evidence collection
  9. Recommendation grading criteria
  10. Method for synthesizing evidence
  11. Pre-release review
  12. Update plan
  13. Definitions
  14. Recommendations and rationale
  15. Potential benefits and harms
  16. Patient preferences
  17. Algorithm
  18. Implementation considerations
references

Shiffman RN, Shekelle P, Overhage JM, Slutsky J, Grimshaw J, Deshpande AM. Standardized reporting of clinical practice guidelines: a proposal from the Conference on Guideline Standardization. Ann Intern Med. 2003 Sep 16;139(6):493-8.

[PubMed]   [Ann Intern Med]

 " Despite enormous energies invested in authoring clinical practice guidelines, the quality of individual guidelines varies considerably. The Conference on Guideline Standardization (COGS) was convened in April 2002 to define a standard for guideline reporting that would promote guideline quality and facilitate implementation. Twenty-three people with expertise and experience in guideline development, dissemination, and implementation participated. A list of candidate guideline components was assembled from the Institute of Medicine Provisional Instrument for Assessing Clinical Guidelines, the National Guideline Clearinghouse, the Guideline Elements Model, and other published guideline models. In a 2-stage modified Delphi process, panelists first rated their agreement with the statement that "[Item name] is a necessary component of practice guidelines" on a 9-point scale. An individualized report was prepared for each panelist; the report summarized the panelist's rating for each item and the median and dispersion of rankings of all the panelists. In a second round, panelists separately rated necessity for validity and necessity for practical application. Items achieving a median rank of 7 or higher on either scale, with low disagreement index, were retained as necessary guideline components. Representatives of 22 organizations active in guideline development reviewed the proposed items and commented favorably. Closely related items were consolidated into 18 topics to create the COGS checklist. This checklist provides a framework to support more comprehensive documentation of practice guidelines. Most organizations that are active in guideline development found the component items to be comprehensive and to fit within their existing development methods. "

Shiffman RN, Michel G. Toward improved guideline quality: using the COGS statement with GEM. Medinfo. 2004;11(Pt 1):159-63.

[PubMed]   []

" The Conference on Guideline Standardization (COGS) was convened to create a standardized documentation checklist for clinical practice guidelines in an effort to promote guideline quality and facilitate implementation. The statement was created by a multidisciplinary panel using a rigorous consensus development methodology. The Guideline Elements Model (GEM) provides a standardized approach to representing guideline documents using XML. In this work, we demonstrate the sufficiency of GEM for describing COGS components. Using the mapping between COGS and GEM elements we built an XSLT application to examine a guideline's adherence (or non-adherence) to the COGS checklist. Once a guideline has been marked up according to the GEM hierarchy, its knowledge content can be reused in multiple ways. "
start date end date location support
Convened in April 2002
 n/a USA. Co-ordinated by Yale University Agency for Healthcare Research and Quality
contact Links
Richard Shiffman, Yale Center for Medical Informatics

E: richard.shiffman@yale.edu 		 bullet   COGS (Yale University)  bullet   The COGS checklist for reporting clinical guidelines
Entry in directory: February 18 2004
Last main update: February 18 2004

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