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An International Needs Assessment Survey of Guideline Developers Demonstrates Variability in Resources and Challenges to Collaboration between Organizations



The development of rigorous, high-quality clinical guidelines increases the need for resources and skilled personnel within guideline-producing organizations. While collaboration between organizations provides a unique opportunity to pool resources and save time and effort, the collaboration presents its own unique challenges.


To assess the perceived needs and current challenges of guideline producers worldwide related to guideline development and collaboration efforts.


Survey questions were developed by the Guidelines International Network and the US GRADE Network, pilot-tested among attendees of a guideline development workshop, and disseminated electronically using convenience and snowball sampling methods.


A total of 171 respondents representing 30 countries and more than 112 unique organizations were included in this analysis.

Main Measures

The survey included free-response, multiple-choice, and seven-point Likert-scale questions. Questions assessed respondents’ perceived value of guidelines, resource availability and needs, guideline development processes, and collaboration efforts of their organization.

Key Results

Time required to develop high-quality systematic reviews and guidelines was the most relevant need (median=7; IQR=5.5–7). In-house resources to conduct literature searches (median=4; IQR=3–6) and the resources to develop rigorous guidelines rapidly (median=4; IQR=2–5) were perceived as the least available resources. Difficulties reconciling differences in guideline methodology (median=6; IQR=4–7) and the time required to establish collaborative agreements (median=6; IQR=5–6) were the most relevant barriers to collaboration between organizations. Results also indicated a general need for improvement in conflict of interest (COI) disclosure policies.


The survey identified organizational challenges in supporting rigorous guideline development, including the time, resources, and personnel required. Connecting guideline developers to existing databases of high-quality systematic reviews and the use of freely available online platforms may facilitate guideline development. Guideline-producing organizations may also consider allocating resources to hiring or training personnel with expertise in systematic review methodologies or utilizing resources more effectively by establishing collaborations with other organizations.

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Data Availability

The datasets generated during and/or analyzed during this study are available from the corresponding author on reasonable request.


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Members of USGN (in alphabetical order)

Philipp Dahm, MD, MHSc; Yngve Falck-Ytter, MD; Rebecca L. Morgan, PhD, MPH; M. Hassan Murad, MD; Reem A. Mustafa, MD, MPH, PhD; Madelin R. Siedler, MA, MS; Shahnaz Sultan, MD, MHSc

Members of Collaboration WG (in alphabetical order)

Murad Alam, MD, MSCI, MBA; Lisa A. Fatheree; Thomas S. D. Getchius; Pamela K. Ginex, EdD, RN, OCN; Priya Jakhmola; Emma McFarlane; Rebecca L. Morgan, PhD, MPH; Toju Ogunremi, MSc; Robyn L. Temple Smolkin, MBA, PhD, HCLD

Author information




Project conceptualization: LF, TG, PG, RLM, TO, SS, RAM, MHM, YFY

Survey development: LF, PJ, TO, RTS, RLM, SS, RAM, MHM, MRS

Analysis: MRS, SS, RLM, BYK

Writing: SS, MRS, RAM, RLM

Reviewing and approval of final manuscript: All

Corresponding author

Correspondence to Shahnaz Sultan MD, MHSc.

Ethics declarations

Conflict of Interest

The authors declare that they do not have a conflict of interest.

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Shahnaz Sultan and Madelin R. Siedler are co-first authors.

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Sultan, S., Siedler, M.R., Morgan, R.L. et al. An International Needs Assessment Survey of Guideline Developers Demonstrates Variability in Resources and Challenges to Collaboration between Organizations. J GEN INTERN MED (2021).

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Key Words

  • guidelines
  • needs assessment
  • collaboration
  • guideline international network