RT Journal Article
SR Electronic
T1 The validity of recommendations from clinical guidelines: a survival analysis
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP 1211
OP 1219
DO 10.1503/cmaj.140547
VO 186
IS 16
A1 García, Laura Martínez
A1 Sanabria, Andrea Juliana
A1 Álvarez, Elvira García
A1 Trujillo-Martín, Maria Mar
A1 Etxeandia-Ikobaltzeta, Itziar
A1 Kotzeva, Anna
A1 Rigau, David
A1 Louro-González, Arturo
A1 Barajas-Nava, Leticia
A1 Campo, Petra Díaz del
A1 Estrada, Maria-Dolors
A1 Solà, Ivan
A1 Gracia, Javier
A1 Salcedo-Fernandez, Flavia
A1 Lawson, Jennifer
A1 Haynes, R. Brian
A1 Alonso-Coello, Pablo
A1 
YR 2014
UL http://www.cmaj.ca/content/186/16/1211.abstract
AB Background: Clinical guidelines should be updated to maintain their validity. Our aim was to estimate the length of time before recommendations become outdated.Methods: We used a retrospective cohort design and included recommendations from clinical guidelines developed in the Spanish National Health System clinical guideline program since 2008. We performed a descriptive analysis of references, recommendations and resources used, and a survival analysis of recommendations using the Kaplan–Meier method.Results: We included 113 recommendations from 4 clinical guidelines with a median of 4 years since the most recent search (range 3.9–4.4 yr). We retrieved 39 136 references (range 3343–14 787) using an exhaustive literature search, 668 of which were related to the recommendations in our sample. We identified 69 (10.3%) key references, corresponding to 25 (22.1%) recommendations that required updating. Ninety-two percent (95% confidence interval 86.9–97.0) of the recommendations were valid 1 year after their development. This probability decreased at 2 (85.7%), 3 (81.3%) and 4 years (77.8%).Interpretation: Recommendations quickly become outdated, with 1 out of 5 recommendations being out of date after 3 years. Waiting more than 3 years to review a guideline is potentially too long.