All in this together: lessons from international guideline developers on collaboration to reduce duplication and enable success in living guidelines

Objective: To describe experiences of collaborations in producing living guidelines by the Australian Living Evidence Consortium (ALEC), the World Health Organization (WHO), the National Institute for Health and Care Excellence (NICE), the Danish Health Authority (DHA), the Knowledge Institute of the Dutch Association of Medical Specialists, and the Canadian Rheumatology Association (CRA).

Methods: We developed a survey to collect the experiences of the collaborations in living guidelines. We collated the results and conducted a quantitative analysis for closed-ended survey questions. For open-ended questions we conducted a content analysis from the survey content.

Results: We included a convenience sample of twelve participants, from six living guideline collaborations across seven organisations. The consolidated results of the quantitative and content analyses were organized in the following themes: 1) facilitators of successful living collaboration, 2) barriers to successful living collaboration, 3) living influence on collaboration, 4) deciding to collaborate, 5) establishing mechanisms of collaboration, 6) communication and coordination of the collaboration, 7) sharing information, 8) publication, authorship, and recognition, and 9) evaluation.

Conclusion: The living guidelines collaborations were developed informally and are still ongoing. They resulted in successful coordination of key parts of the guideline process, including sharing of searches for evidence, data extractions and evidence summaries. Future living guidelines collaborations could benefit from early initiation and discussion of data sharing requirements, agreement of shared goals and questions, and regular evaluations.