NGC's Revised Inclusion Criteria
What are the main changes to the inclusion criteria?
The two main changes are:
- Documentation will need to be provided showing that the guideline is based upon a systematic review of the evidence.
- Documentation must contain an assessment of the benefits and harms of the recommended care and alternative care options.
How will these changes affect the submission process? What documents* are required?
Starting June 2014, NGC will require more detailed information to verify that the guideline is based on a systematic review of the evidence and that there was an assessment of the benefits and harms of the recommended care and alternative care options. See Revised Inclusion Criteria 3 and 4 for a description. Documents required to meet inclusion include:
- Original guideline document(s)
- Document(s) detailing the specific methodology for the evidence underpinning the guideline(s) (e.g., systematic reviews, evidence syntheses, technology assessment reports)
- Either of the above must also include an assessment of the benefits and harms of the recommended care and alternative care options.
Other supporting documents that describe the developer's process for guideline development may also be submitted.
*Documents may be submitted in either print or electronic form (preferred) including PDF, HTML, or the URL(s) where access can be obtained.
What documentation is required to ensure the guideline was developed, reviewed, or revised within the past 5 years?
Starting June 2014, all new/updated guidelines submitted to NGC must be based on a recent systematic review. Currency will be established by review of the following: a description of the search strategy that includes a listing of database(s) searched, a summary of search terms used, the specific time period covered by the literature search including the beginning date (month/year) and end date (month/year), and the date(s) when the literature search was performed. In addition, the guideline's bibliography will be assessed for consistency with the date ranges of the literature searches.
What if the documentation is not published or in a report?
NGC staff will follow up with guideline developers on an individual basis for any missing documentation. In situations where the documentation may not sufficiently meet the inclusion requirements, the submission will be reviewed by NGC senior staff, members of the Editorial Board, and by AHRQ for a final determination.
How will I know which guidelines in NGC meet the new/revised criteria?
The revised inclusion criteria will be implemented in June 2014. There will be a distinction made between guidelines that meet the new criteria from those accepted under the prior criteria, however the specific mechanism to differentiate them will not be announced until June 2014.
How do the revised criteria help me evaluate the guidelines in NGC?
NGC's revised inclusion criteria reflect the 2011 Institute of Medicine (IOM) definition of a clinical practice guideline. The definition emphasizes two important aspects of a guideline that should be represented in good evidence-based guidelines: being based on a systematic review and assessing the benefits and harms of recommended care and alternative care options. These revised inclusion criteria ensure that guidelines in NGC will meet this new minimum standard.
My NGC Personalization
What features are available for "My NGC" personalization?
- My Recent Searches: Terms you have recently searched appear on the home page directly below the main search box. Your three most recent searches are displayed ("View all…" will display up to 10 recent searches); clicking the term will run the search and display up-to-date results for that term (no account creation required).
- My Recently Viewed Guideline Summaries: Guideline summaries you have recently viewed appear on the home page. Your five most recently viewed summaries are displayed; clicking a title will display the summary page (no account creation required).
- My Favorite Organizations: You can save an organization as a "favorite." There is no limit to the number of organizations you can save to favorites. You will have the option to receive weekly e-mail alerts when a new summary or summaries associated with that organization have been published or if one or more summaries associated with that organization have been updated or withdrawn from the site.
How to save an organization as a favorite: In the By Organization browse, clicking on the star next to the organization's name will cause a pop-up window to appear allowing you to save the organization as a "favorite." Similarly, if you browse directly to an organization, you can save it as a "favorite" by clicking "Save to Favorites" in the top right corner of the organization results page (account creation required).
- Topic Alerts: You can sign up for e-mail alerts on topics of interest. The NGC topics have been chosen based on resources such as Healthy People 2020 and relevant content in the NGC database. An alert will be sent when a summary or summaries, associated with that topic, have been published, updated, or withdrawn.
- Expert Commentary Alerts: You can sign up to receive an alert when a new expert commentary is published to the NGC site.
- My E-mail Alerts: Defined by favorite content, you can receive weekly e-mail alerts when your favorite content is published, updated, or withdrawn (account creation required). Refer to "What types of custom e-mail alerts are available and how can I sign up?" below for further information.
View the new My NGC Tutorial on how to use personalization features.
How can I sign up for a free account?
You can create an account directly from the home page, by clicking the My NGC button in the left navigation, or by clicking the Sign in link in the top right corner of the site. To create an account, enter an e-mail address (required), password (required), password confirmation (required), first name (optional), and last name (optional).
What types of custom e-mail alerts are available and how can I sign up?
Every Monday, you will receive of digest of personalized content. Note: You will not receive an e-mail unless there are changes to your favorite content.
Alerts are available on any or all of the following:
- How to sign up for Favorite Guideline/Measure Summary Alerts: Favorite summary alerts are accessible from your My NGC Dashboard (account creation required). You may also sign-up to receive favorite summary alerts when you save a summary to your favorites via the pop-up window. An alert will be sent when your favorite summary or summaries have been updated or withdrawn from the site.
- How to sign up for Favorite Organization Alerts: Favorite organization alerts are accessible from your My NGC Dashboard (account creation required). You may also sign-up to receive Favorite Organization alerts when you save an organization to your favorites via the pop-up window. An alert will be sent when a new summary or summaries associated with that organization have been published or if one or more summaries associated with that organization have been updated or withdrawn.
- How to sign up for Topic Alerts: Topic alerts are accessible from your My NGC Dashboard (account creation required). By clicking "Add Topic Alerts" a pop-up window will appear with a list of available topics. A "Create Topic E-Mail Alerts" button is also accessible from the By Topic browse. An alert will be sent when a summary or summaries, associated with a topic, have been published, updated, or withdrawn.
- How to sign up for Expert Commentary Alerts: Expert Commentary alerts are accessible from your My NGC Dashboard (account creation required). A "Create Expert Commentary E-Mail Alerts" button is also accessible from the Expert Commentaries landing page. An alert will be sent when a new Expert Commentary is published to the site.
How often are My NGC e-mail alerts issued?
E-mail alerts are issued weekly on Monday. Note: You will not receive a My NGC e-mail alert unless there are changes to your favorite content. Personal alerts will not affect the NGC/NQMC weekly e-mail (you will continue to receive this e-mail separately every Monday if you have subscribed).
How can I opt out of the passive personalization (My Recent Searches and My Recently Viewed Summaries) features?
In order to prevent recent searches and recently viewed summaries from being tracked, you must disable cookies in your Web browser. In Internet Explorer 9, click on Tools, then Internet Options, and then click on the Privacy tab. Next, click on the Advanced button and select the "Override automatic cookie handling" option. Next, block first-party cookies, and click OK. Clear your internet browser cache, close all open browsers, and return to the NGC home page.
Why don't all of the summaries include references supporting the recommendations?
NGC uses a systematic approach to decide when it is appropriate to include author, year citations in the Major Recommendations field and full citations in the References Supporting the Recommendations field. Two criteria drive the decision-making process: (1) the recommendations are explicitly stated, and (2) those explicit statements are referenced. The first criterion means that the recommendations in the guideline document are easily identified, stand-alone, action-oriented statements. Explicit recommendation statements are not interspersed among rationale in the guideline document. Rationale for the recommendations may be provided in sections before or after the actual recommendations but not within the same body of content as the recommendations. The second criterion means that the reference(s) supporting the explicit recommendation is (are) provided at the end of the statement. References cited in the rationale for the recommendation are not captured.
What are UMLS concepts, and how are they used on NGC?
The U.S. National Library of Medicine (NLM) has developed the Unified Medical Language System (UMLS) to "facilitate the development of computer systems that behave as if they "understand" the meaning of the language of biomedicine and health. The UMLS consists of three knowledge sources, the Metathesaurus, the Semantic Network, and the Specialist Lexicon, as well as computer tools to help developers integrate the information from these sources.
The Metathesaurus is a collection of more than 100 controlled vocabularies, thesauri, and code sets linked together via high-level semantic concepts. NGC's master's level indexers apply terms from selected UMLS vocabularies to each guideline summary, expert commentary, and guideline synthesis to facilitate searching and browsing and to create relationships between similar documents. These vocabularies are:
- Healthcare Common Procedure Coding System (HCPCS)
- International Classification of Diseases – Clinical Modification (ICD-9-CM)
- Medical Subject Headings (MeSH)
- Physician Data Query (PDQ)
- Standard Product Nomenclature (SPN)
- Systemized Nomenclature of Medicine (Clinical Terms) (SNOMED CT)
- UMLS Metathesaurus (MTH)
- Universal Medical Device Nomenclature System (UMDNS)
Guideline Submissions, Current Inclusion Criteria, Copyright Permission
Are there copyright restrictions on the information accessed through the NGC Web site at www.guideline.gov?
There are no copyright restrictions that prevent users from copying and/or distributing content found on NGC, provided that all content is appropriately identified. NGC's content (i.e., guideline summaries, guideline syntheses, and expert commentaries) is available for public use, and we encourage the distribution of our content, particularly for educational purposes. NGC content may not be used for commercial and/or product endorsement purposes.
Although most of NGC's content is free of restrictions, exceptions occur where individual guideline developers have requested otherwise. Refer to the Copyright Statement field at the end of each summary to determine if whether such restrictions apply and if users need to contact the guideline developer.
NGC seeks and receives permission from guideline developers to include summaries of the original full-text guidelines that appear at www.guideline.gov. NGC does not have the authority to grant copyright clearance for the original full-text guidelines upon which the summaries are based. If you are interested in using/distributing the original full-text guideline, you must contact the guideline developer.
What are examples of supporting documents that can be submitted to NGC?
Guideline developers submit a variety of documents to NGC including the following:
- Original guideline document(s)
- Documents detailing the specific methodology for the guideline (e.g., systematic reviews, evidence syntheses, technology assessment reports)
- Documents describing the developer's process for guideline development
- Patient resources (fact sheets, patient versions of guideline recommendations, pamphlets/brochures, etc.)
- Tools to assist in implementation (quick reference guides, mobile device resources, pocket guides, algorithms, order sets, chart documentation, slide sets, etc.)
- Continuing Medical Education (CME) material
- Other companion documents (e.g., background material, costing statements)
How can I find guidelines on a specific topic?
You can type your search term in the search box accessible in the masthead of all NGC Web pages to quickly search the database. You can also browse the NGC database by Topic (Disease/Condition, Treatment/Intervention, Health Services Administration) or Organization.
The About Search page contains useful tips on how to search the NGC database for guidelines of interest. You can also use Advanced Search to perform refined searches of the NGC database. This feature allows you to filter your search by one or more guideline attributes (e.g., Clinical Specialty, Intended Users, Guideline Category).
What is the difference between the Find, Search, and Advanced Search features?
Technically, NGC offers three ways to find guidelines: Browse, Search, and Advanced Search. The "Find" heading on the home page directs users to the various "browse" features on the Web site that can be found in the left-hand navigation menu under the "Guidelines" button. These browses include: Browse by Topic, Browse by Organization, Browse Guidelines in Progress, Browse Guideline Index, Browse Guideline Archives, Browse Related NQMC Measures.
"Search," also known as "basic search" or "main search" is accessed via the search box on the home page or globally in the masthead. The NGC search engine operates by seeking matches with search terms from two distinct types of data pulled from the contents of NGC: layer of semantic metadata associated with a content piece, and the exact matches of words or phrases in the text. See About Search for additional information.
The "Advanced Search" leverages the power of the main/basic search engine while also allowing the user to select specific subsets of guideline summaries. The total data set is narrowed as the user selects filters to refine their search results. See About Search for additional information.
Are guideline summaries available in a downloadable format?
Each guideline summary provides a printable view via the Print link and several download types: PDF (download the free Adobe Reader ), Word (compatible with Word 1997 and higher), HTML, and XML. A citation for individual guideline summaries can also be downloaded into EndNote by clicking on the Citation Manager link.
What is the difference between a "clinical guideline," "practice parameter," and "standard"?
Evidence-based clinical guidance documents are heterogeneous, as is the terminology utilized to describe and/or label them. The phrases "guideline," "protocol," "practice parameter," "pathway," "standard," etc., are used in many different contexts by different guideline developers. Any document meeting NGC's Inclusion Criteria is eligible for inclusion, regardless of how it is labeled.
How do I obtain the original full-text guideline upon which the NGC guideline summary is based?
For guidelines for which NGC has received the necessary permissions from the guideline developer, links are provided from the NGC summary to the full-text document at the developer's Web site. Users can find this link by referring to the "Related Content" tab at the top of each summary or by going to the Guideline Availability field that appears near the end of each summary. NGC is unable to fulfill orders for printed copies of the original full-text document.
How do I cite the information found at the NGC Web site (e.g., a guideline summary, guideline synthesis, or expert commentary)?
The suggested citation format for a Guideline Summary:
- National Guideline Clearinghouse (NGC). Guideline summary: [insert title of summary]. In: National Guideline Clearinghouse (NGC) [Web site]. Rockville (MD): Agency for Healthcare Research and Quality (AHRQ); [cited YYYY Mon DD]. Available: http://www.guideline.gov.
Example: National Guideline Clearinghouse (NGC). Guideline summary: Screening for breast cancer. In: National Guideline Clearinghouse (NGC) [Web site]. Rockville (MD): Agency for Healthcare Research and Quality (AHRQ); [cited 2010 Jul 21]. Available: http://www.guideline.gov.
The suggested citation format for a Guideline Synthesis:
- National Guideline Clearinghouse (NGC). Guideline synthesis: [insert title of synthesis]. In: National Guideline Clearinghouse (NGC) [Web site]. Rockville (MD): Agency for Healthcare Research and Quality (AHRQ); [cited YYYY Mon DD]. Available: http://www.guideline.gov.
Example: National Guideline Clearinghouse (NGC). Guideline synthesis: Screening for breast cancer. In: National Guideline Clearinghouse (NGC) [Web site]. Rockville (MD): Agency for Healthcare Research and Quality (AHRQ); [cited 2010 May 7]. Available: http://www.guideline.gov.
If you are citing the original guideline upon which the summary or synthesis is based, please refer to the Source field included in each guideline summary or the sources listed under the Guidelines Being Compared section found at the top of each guideline synthesis.
The suggested citation format for an Expert Commentary:
- Author [insert Commentary author]. Commentary title. In: National Guideline Clearinghouse (NGC) [Web site]. Rockville (MD): Agency for Healthcare Research and Quality (AHRQ); [cited YYYY Mon DD]. Available: http://www.guideline.gov.
Example: Wachter RM. Is the Measurement Mandate Diverting the Patient Safety Revolution? In: National Guideline Clearinghouse (NGC) [Web site]. Rockville (MD): Agency for Healthcare Research and Quality (AHRQ); [cited 2009 Nov 8]. Available: http://www.guideline.gov.