The Canadian Society of Nephrology Methods for Developing and Adapting Clinical Practice Guidelines: An Update
Purpose of the review: In this article, we provide an update on the Canadian Society of Nephrology’s (CSN) process of identifying candidate topics and subsequent development of guidelines and commentaries using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE)-ADOLOPMEN...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2025-06-01
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| Series: | Canadian Journal of Kidney Health and Disease |
| Online Access: | https://doi.org/10.1177/20543581251346074 |
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| author | Somaya Zahran Anna Mathew Tyrone G. Harrison Arenn Jauhal Michelle A. Hladunewich Reem A. Mustafa |
| author_facet | Somaya Zahran Anna Mathew Tyrone G. Harrison Arenn Jauhal Michelle A. Hladunewich Reem A. Mustafa |
| author_sort | Somaya Zahran |
| collection | DOAJ |
| description | Purpose of the review: In this article, we provide an update on the Canadian Society of Nephrology’s (CSN) process of identifying candidate topics and subsequent development of guidelines and commentaries using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE)-ADOLOPMENT methodology. We revise the process of adapting existing guidelines with the inclusion of Kidney Disease Improving Global Outcomes (KDIGO) practice points. We also describe challenges of implementing guidelines and suggest solutions to address this with description of the CSN approach to disseminating and implementing guidelines. Sources of information: The update reflects internal CSN documentation, stakeholder consultation for topic prioritization, and integration of methodological guidance from GRADE-ADOLOPMENT and international sources such as KDIGO. Methods: We reviewed and synthesized the CSN’s current guideline-development process, which includes a detailed examination of internal documentation, meeting summaries, and publicly available methodological frameworks with specific focus on the application of the GRADE-ADOLOPMENT approach. We analyzed how recommendations and practice points from KDIGO are assessed for relevance, updated based on Canadian context, and integrated into the final commentary using GRADE Evidence-to-Decision (EtD) frameworks. We also examined how conflict of interest is managed, how working groups are structured, and how recommendations are prioritized. In addition, we explored the CSN’s evolving strategies for dissemination and implementation, including stakeholder engagement, survey feedback, and use of knowledge-translation tools. Key findings: The CSN follows a transparent and rigorous process in guideline and commentary development. This comprehensive process considers the best-available evidence, balancing desirable and undesirable effects and patients’ values, perspectives, and implications for the Canadian health care system including resources, equity, acceptability, and feasibility to maximize guideline implementation and advance the health of Canadians. Limitations: The CSN updated methods reflect the current process and may not be generalizable to other guideline organizations. The impact of CSN commentaries on clinical practice, decision-making, and policy uptake has not been formally evaluated, limiting our understanding of their contribution to health system improvement and patient outcomes. Implications: This review updates the CSN’s processes for commentary working groups to identify relevant international guidelines, establish the level of agreement on included recommendations, incorporate perspectives of people with lived experience, and adjust the final product to the Canadian healthcare system before dissemination. |
| format | Article |
| id | doaj-art-30a27c54b56e43ad84d233050c7670eb |
| institution | Kabale University |
| issn | 2054-3581 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Canadian Journal of Kidney Health and Disease |
| spelling | doaj-art-30a27c54b56e43ad84d233050c7670eb2025-08-20T03:27:58ZengSAGE PublishingCanadian Journal of Kidney Health and Disease2054-35812025-06-011210.1177/20543581251346074The Canadian Society of Nephrology Methods for Developing and Adapting Clinical Practice Guidelines: An UpdateSomaya Zahran0Anna Mathew1Tyrone G. Harrison2Arenn Jauhal3Michelle A. Hladunewich4Reem A. Mustafa5Division of Nephrology, Department of Medicine, McGill University, Montreal, Quebec, CanadaDivision of Nephrology, Department of Medicine, McMaster University, Hamilton, Ontario, CanadaLibin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, CanadaDivision of Nephrology, Department of Medicine, University Health Network, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, CanadaDivision of Nephrology, Department of Medicine, Sunnybrook Health Sciences Centre, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, CanadaDepartments of Internal Medicine and Population Health, University of Kansas Health System, Kansas City, KS, USAPurpose of the review: In this article, we provide an update on the Canadian Society of Nephrology’s (CSN) process of identifying candidate topics and subsequent development of guidelines and commentaries using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE)-ADOLOPMENT methodology. We revise the process of adapting existing guidelines with the inclusion of Kidney Disease Improving Global Outcomes (KDIGO) practice points. We also describe challenges of implementing guidelines and suggest solutions to address this with description of the CSN approach to disseminating and implementing guidelines. Sources of information: The update reflects internal CSN documentation, stakeholder consultation for topic prioritization, and integration of methodological guidance from GRADE-ADOLOPMENT and international sources such as KDIGO. Methods: We reviewed and synthesized the CSN’s current guideline-development process, which includes a detailed examination of internal documentation, meeting summaries, and publicly available methodological frameworks with specific focus on the application of the GRADE-ADOLOPMENT approach. We analyzed how recommendations and practice points from KDIGO are assessed for relevance, updated based on Canadian context, and integrated into the final commentary using GRADE Evidence-to-Decision (EtD) frameworks. We also examined how conflict of interest is managed, how working groups are structured, and how recommendations are prioritized. In addition, we explored the CSN’s evolving strategies for dissemination and implementation, including stakeholder engagement, survey feedback, and use of knowledge-translation tools. Key findings: The CSN follows a transparent and rigorous process in guideline and commentary development. This comprehensive process considers the best-available evidence, balancing desirable and undesirable effects and patients’ values, perspectives, and implications for the Canadian health care system including resources, equity, acceptability, and feasibility to maximize guideline implementation and advance the health of Canadians. Limitations: The CSN updated methods reflect the current process and may not be generalizable to other guideline organizations. The impact of CSN commentaries on clinical practice, decision-making, and policy uptake has not been formally evaluated, limiting our understanding of their contribution to health system improvement and patient outcomes. Implications: This review updates the CSN’s processes for commentary working groups to identify relevant international guidelines, establish the level of agreement on included recommendations, incorporate perspectives of people with lived experience, and adjust the final product to the Canadian healthcare system before dissemination.https://doi.org/10.1177/20543581251346074 |
| spellingShingle | Somaya Zahran Anna Mathew Tyrone G. Harrison Arenn Jauhal Michelle A. Hladunewich Reem A. Mustafa The Canadian Society of Nephrology Methods for Developing and Adapting Clinical Practice Guidelines: An Update Canadian Journal of Kidney Health and Disease |
| title | The Canadian Society of Nephrology Methods for Developing and Adapting Clinical Practice Guidelines: An Update |
| title_full | The Canadian Society of Nephrology Methods for Developing and Adapting Clinical Practice Guidelines: An Update |
| title_fullStr | The Canadian Society of Nephrology Methods for Developing and Adapting Clinical Practice Guidelines: An Update |
| title_full_unstemmed | The Canadian Society of Nephrology Methods for Developing and Adapting Clinical Practice Guidelines: An Update |
| title_short | The Canadian Society of Nephrology Methods for Developing and Adapting Clinical Practice Guidelines: An Update |
| title_sort | canadian society of nephrology methods for developing and adapting clinical practice guidelines an update |
| url | https://doi.org/10.1177/20543581251346074 |
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