Background
While there is already strong qualitative evidence of WHO normative product use at the country level, monitoring their impact should be much stronger. Currently, there is not a standardized way to monitor across different normative products and technical areas of work. To address this gap, WHO has developed a systematic approach to report to what extent such products are used and useful, to inform decision-making and ensure accountability.

Objective
To develop a systematic approach for monitoring and reporting the impact of WHO normative products at country level.

Methods
The concept of the approach and its three dimensions (dissemination, use and impact) was initially reviewed for applicability and feasibility with emergency care guidance in Ethiopia and Kenya. The approach tools were subsequently piloted with the Neglected Tropical Diseases Programme and the Human Reproduction Programme in Ethiopia and Pakistan, in collaboration with WHO-three level and partners.

Results
The initial review found the three proposed dimensions were applicable and feasible across the two countries and products. The impact reports from the pilot (currently for clearance with relevant stakeholders) provide key information under each dimension, demonstrating the potential of this approach to be robust, efficient, and scalable across different technical areas, products and country contexts.

Discussion
Further application and mainstreaming will be essential for the refinement of the approach and its scalability. Use and impact of a normative product are linked to the health ecosystem (system, factors and actors) of the country considered, that is context-specific and need to be accounted for.

Introduction
Creating a cohesive framework for health decision-making and research is crucial for the development of effective national health policies. This framework merges Clinical Practice Guidelines (CPG) with Health Technology Assessment (HTA), ensuring that policy decisions are grounded in evidence and adhere to optimal clinical practices.
Methods
CPGs deliver well-founded recommendations to assist healthcare providers and patients in making informed clinical choices. In Tunisia, the collaboration between CPG and HTA departments, along with other sectors of the Ministry of Health (MOH), plays a vital role in shaping national health policies. Additionally, the implementation of Care Pathways for chronic diseases and conditions with significant population impact helps to alleviate pressure on tertiary care and contributes to the development of better health policies. The concept of a "basket of care" includes prevention, diagnosis, treatment, and rehabilitation services for common diseases and chronic conditions, ensuring equity and accessibility of healthcare
Results
These departments collaborate to evaluate new health technologies, revise clinical guidelines, and respond to emerging health issues. Their joint efforts guarantee that health policies are scientifically validated and practically implementable.
Conclusion
By utilizing the expertise of the CPG and HTA departments, the MOH enhances the quality of care and patient outcomes nationwide while developing the "National Health Policy." The integrated framework and the introduction of the "basket of care" concept emphasize the significance of diverse contributions in effectively guiding health decision-making and research, ensuring equitable access to essential healthcare services

Background: Jaundice is a very common condition during neonatal period. Nevertheless, the use of clinical guidelines to manage neonatal jaundice in Taiwan was not evaluated yet.
Objective: To determine the use of guidelines for the management of neonatal jaundice in Taiwan.
Methods: We developed a structured questionnaire in 2024 and delivered this questionnaire via online system to healthcare personnel (HCP) of 9 postpartum centers, 3 obstetric hospitals and 5 medical centers. A multivariate logistic regression model was used to analyzed the factors in relation to the use of clinical guidelines.
Results: A total of 299 participants were enrolled into this study, including 36 physicians and 263 nurses. Approximately two-thirds of HCP managed neonatal jaundice based on clinical guidelines. Guidelines written in Chinese were most-commonly used. HCP more often used clinical guidelines to manage neonatal jaundice with the following characteristics – male, physician, working in medical center, high attainment of education, and director position. The multivariate logistic regression analysis showed physician, working in medical center, high level of education, and director position were the significant factor to implement clinical guidelines.
Conclusions: This study determined the factors in relation to the implementation of clinical guidelines for the management of neonatal jaundice. The results suggest educational training and development of Chinese guidelines could be better ways to disseminate the implementation of clinical guidelines for the management of neonatal jaundice.

Background

Incorporating the perspectives of children and youth in the development of pediatric guidelines is essential for ensuring their needs and experiences are accurately represented. However, due to their vulnerability, direct involvement must be approached with caution. An alternative is to involve parents as proxies, though this raises the question of whether parental perspectives, values and opinions accurately reflect those of their children. 

One proposed method is a two-step process: first exploring parents' own views, then prompting them to adopt their child’s perspective, thereby minimizing personal bias. This approach aims to focus more clearly on the point of view of their child.

Objective  

We aim to explore two key questions:

What factors must be considered to responsibly and meaningfully incorporate children’s and youth’s perspectives in guideline development?

How can parents be involved as proxies while ensuring their perspectives, values, and opinions authentically represent those of their child?

Methods

During the development of the guideline on obesity in children and youth, we are involving parents as proxies for their children. As part of this approach, we will assess its benefits, implement the two-step process, and explore further strategies, all while ensuring that the child's perspective remains central and is continually prioritised.

Future prospects for project presentations 

In the coming months, we will refine this approach and expand our methodological framework for similar guidelines. Our findings will be presented as a poster at the GIN conference, contributing to best practices for integrating child and youth perspectives in guideline development.

Background: The European Academy of Neurology (EAN) develops and publishes clinical practice guidelines (CPG). However, patient summaries for these CPGs are lacking. To address this gap, we aim to develop guidance for the creation, dissemination, and implementation of patient summaries. Additionally, we seek to better understand how these summaries can be effectively integrated into the existing EAN guideline production framework.
Methods: A mixed-method, multi-stage approach combining qualitative and quantitative methods will be employed. First, a preliminary checklist will be developed based on available literature and guidance from other scientific organizations. Next, drafts of patient summaries (both human-made and AI-generated) for three selected European Academy of Neurology CPGs will be reviewed and voted on by a multidisciplinary working group, including guideline developers, public/patient representatives, and healthcare providers. The group will participate in a focus group to provide feedback on formats, explore acceptability, and identify facilitators and barriers. An online survey will then be conducted to assess the readability, completeness, correctness, comprehensibility, relevance, structure, and overall quality of the summaries. Finally, results will be analyzed, and consensus will be reached to produce the final recommendations.
Future prospects for project presentation: This project will provide structured guidance for developing, disseminating, and implementing patient summaries for EAN CPGs. Future efforts will focus on piloting the recommendations in four new EAN guidelines and assessing their impact on accessibility and patient involvement. Ultimately, the goal is to integrate patient summaries into the EAN guideline framework to improve patient access to reliable, evidence-based information.

Background
Management of patient agitation in the intensive care unit (ICU) is a significant challenge. Despite the encouragement to use nonpharmacological interventions to reduce the adverse effects of medications, existing guidelines predominantly focus on pharmacological management. The lack of guidelines on nonpharmacological strategies can lead to an over-reliance on medications and the underutilization of effective non-pharmacological approaches.

Objective
Through global collaboration, the objective was to develop evidence-based and locally applicable guidelines for nonpharmacological management of patient agitation in adult ICUs in Denmark and Australia.

Methods
The guidelines were developed following the Australian National Health and Medical Research Council guidelines and the Danish Health Authority’s manual on guideline development. The process included early stakeholder consultation, a systematic review and an umbrella review, a modified Delphi study involving 114 experts and stakeholder and methodological reviews of the draft guidelines. The quality of the evidence was assessed using the GRADE approach.

Future prospects for project presentations
Overall, 13 recommendations advocate for a person-centered approach that considers agitation severity, underlying causes, family engagement, comfort, safety and involvement. Although the key recommendations are similar in the Danish and Australian versions, contextual differences will be considered in practice. Successful implementation requires an organization that is ready to support its staff and provide targeted education and resources.
This work demonstrates how it is possible to develop clinical guidelines across countries and tailor them to local contexts. The approach has multiple advantages through the optimization of resources and the sharing of knowledge and best practices across borders.

Background
‘Gezondheid en Wetenschap’ is part of the Belgian Center for Evidence Based Medicine (Cebam). Our website provides reliable information on health and diseases for the general public. Visitors seeking more information are referred to other websites. We are enhancing our review process to make sure these websites are relevant, tailored to our visitors’ needs and above all reliable.

Objective
To describe the review process for websites for further reading.

Methods
An informal consensus method was used: In consultation rounds (with methodological experts) we explored tools to assess the reliability of evidence-based information, such as CAPOCI, AGREE II and the CRAAP test. Next, we rephrased useful criteria of these tools into yes-no questions. We reached consensus over a set of 13 criteria. They are related to target audience, transparency (e.g. who are the authors, what methodology is used), advertising and sponsoring, language and lay-out. Six of them are considered ‘major’ criteria. Five editors started screening websites that we already used based on these criteria. This process is peer-reviewed and documented for transparency and future reference.

If websites don't meet all criteria, the editorial team will discuss whether to withhold them.

Future prospects for project presentations
This formalized review process will improve the quality of our content by identifying sources we incorrectly deemed reliable. Furthermore, by offering constructive feedback to publishers of websites that don’t meet our criteria, we aim to help elevate the (methodological) quality and relevance of public information in Flanders.

Background:
The launch of a prostate cancer screening programme in January 2024 in the Czech Republic required the development of rapid, evidence-based recommendations for urologists and general practitioners to optimise early detection.
Objective:
Based on NIKEZ (The National Institute for Quality and Excellence in Healthcare) Executive Board prioritisation, five key clinical questions were identified regarding the appropriate age to start and stop screening, management of borderline Prostatic specific antigen values, and the impact of LUTS (lower urinary tract symptoms) on screening recommendations.
Methods:
A systematic search was conducted in two rounds over four weeks. International guidelines (GIN Library, BIGG, Epistemonikos) and systematic reviews (MEDLINE, Embase, Web of Science) were analysed. Evidence quality was assessed by two independent experts using the AGREE II and JBI. Recommendations were developed following NIKEZ and GRADE-ADOLOPMENT methodologies, focusing on guidelines and systematic reviews from 2018–2023.
Results:
Five rapid recommendations were developed to ensure a standardised approach to prostate cancer screening in the Czech Republic. Four were based on existing guidelines, while the fifth was developed de novo from a systematic review. The first strong recommendation, defining the optimal age to start screening in men without risk factors, has high-certainty evidence and is linked to a quality indicator.
Conclusions:
These recommendations provide a unified, evidence-based framework for effective prostate cancer screening. Rigorous evidence appraisal enables optimised early detection and improved patient care. Future efforts will focus on developing quality indicators based on these recommendations.

Background: Since 2014, the US GRADE Network/Evidence Foundation (USGN/EF) has provided competency-based workshops on the use of the GRADE approach for rating the certainty of evidence and developing trustworthy recommendations and, more recently, INGUIDE certification.

Objectives: This study assesses the impact of the USGN/EF Guideline Development workshops on the uptake and dissemination of GRADE and guideline development methods.

Methods: We retrospectively queried prospectively collected data on the number of participants, their country of origin and affiliation with professional organizations, as well as information on the type of workshop and format.

Results: USGN/EF has hosted a total of 59 workshops. Most (35; 59.3%) were held in person; the remainder were held in a virtual format (24; 40.7%; first 2019). The total number of trainees was over 1,850, of which at least 188 (approximately 10%) were from outside the US. The median number of participants per workshop was 39.5 (IQR: 22; 50). During this time, the USGN/EF supported a total of 45 scholars with free registration. Most workshops were related to interventions (85.7%); some (n=8) had a special topic focus such as non-randomized studies, sparse evidence, and use of GRADE for time-to-event outcomes. Surveys demonstrated that >90% of participants had ‘increased understanding of how to apply GRADE’ and would ‘recommend the workshop' to others.

Conclusions: The educational impact of the USGN/EF workshops extends beyond US borders and includes both in-person and virtual instructional settings. Over an eleven-year period, over 1,850 trainees participated in experiential, problem-based learning to apply the GRADE framework.

Background: The implementation of clinical practice guidelines (CPG) has been a challenge in health care and requires the development of strategies to reduce the know-do gap. An overview carefully evaluated studies published up to the beginning of 2019 on this topic, but since then new evidence has been published.
Objective: To analyze CPG implementation strategies published as of 2019 in scientific literature.
Methods: An overview to identify systematic reviews (SR) that evaluated CPG implementation strategies and published between 08/10/2019 and 08/28/2024 was conducted. Structured research was conducted in four databases and the same criteria used in the previously published overview were followed. After screening the records, the characteristics of the studies and implementation strategies were extracted.
Results: Of the 2886 records retrieved, seven SR were included. One SR was published in 2019, three in 2020 and three in 2024. Two SR focused on CPG implementation strategies in specific professional areas (dental care and nursing), three in specific clinical areas (cancer, knee osteoarthritis and pain/delirium) and two in general clinical areas. The Effective Practice and Organization of Care (EPOC) was the most used taxonomy to categorize strategies (n=3), followed by the Mazza (n=2), Expert Recommendations for Implementing Change (ERIC) (n=1) and Mindspace framework (n=1). Several implementation strategies were described, among them the educational strategies for healthcare workers (supporting materials, meetings and others) were observed in all studies.
Discussion: The new findings provide evidence of CPG implementation strategies that can be adapted by different stakeholders and healthcare settings.

Background The implementation of guidelines in multimorbidity care poses significant challenges. With limited multimorbidity guidelines, managing such patients often requires applying multiple disease-focused guidelines together, which may result in potential disease and drug interactions adversely impacting patient health.
Objective We aimed to collect and analyze the opinions of key experts on what should be considered when using guidelines to treat or manage multimorbid patients, and to further promote the appropriate implementation of guidelines.
Methods From September 2024 to February 2025, we invited experts in multimorbidity research and practice and guideline development to participate in our interview. Interviewees were selected using purposive non-systematic selection. Subject analysis using Nvivo 12 software was employed to summarize the findings.
Results We interviewed fifteen experts from nine countries. The lack of multimorbidity guidelines and the inapplicability of single-disease guidelines may lead healthcare providers to either rely solely on personal experience or rigidly follow guidelines without considering the needs of individual patients. Major barriers to guideline application include insufficient evidence and limited awareness and training among clinicians in both multimorbidity management and guideline implementation. The interviewees emphasized flexible use of guidelines, prioritizing patient values and preferences, and individualized management goals informed by (rather than strictly adhering to) guidelines.
Discussion for scientific abstracts This interview study highlights significant challenges in applying guidelines to multimorbidity care. Flexible guideline use, comprehensive assessment of the patient’s situation, and prioritizing patient preferences are critical. Future efforts should focus on generating robust multimorbidity evidence and developing decision support tools.

Background: Clinical guidelines must be underpinned by sound evidence to inform patient care. Despite rising research integrity concerns, there are no processes for assessing evidence integrity in guideline development.

Objective: In response to this crucial gap, we developed the Research Integrity in Guidelines and evIDence synthesis (RIGID) framework, an innovative and transparent six-step approach, with a central integrity committee.

Methods: Co-developed with international input from 80 multidisciplinary experts, and consumers, the RIGID framework follows six key steps: (1) Review processes are adopted, in line with approved evidence synthesis methodologies; (2) Exclude studies which have been retracted, and note those with expressions of concern for further evaluation; (3) Assess remaining studies for integrity using an appropriate tool and allocate an initial integrity risk rating (low, moderate, high); (4) Discuss assessment results among integrity committee members with votes to determine final study integrity risk ratings; (5) Establish contact with authors for clarification of studies ranked as moderate or high risk; (6) Reassess studies for inclusion using the RIGID author response algorithm.

Findings: An illustrative case study demonstrates how RIGID was successfully implemented in an influential international guideline endorsed by 39 societies across six continents. Here, 45 of the 101 eligible studies (45%) were not included in the guideline due to integrity concerns. The RIGID framework has since been successfully implemented in two further guidelines in women's health.

Discussion: Based on the latest literature and international expertise, the RIGID framework represents an important advancement in best practice standards for guideline development.

Background
Many developers require a majority of a guideline panel to have zero financial conflicts of interest. This approach has two disadvantages: First, scrupulous collection and review of sometimes trivial financial disclosures creates high administrative burden. Second, use of two standards (a stringent one for an “unconflicted” majority, and an unlimited one for a “conflicted” minority) generates resentment about unfairness. From 2020 to 2025, the American Society of Hematology (ASH) implemented a new conflict of interest policy that includes a simple rule: All participants on an ASH guideline panel must avoid direct financial payments from for-profit healthcare companies > $X per year, considering all payments for all activities in aggregate per year regardless of relevance to the guideline topic. From 2020 through 2022, X was set at $5,000 (USD); from 2023 through 2025, at $7,500.

Objective
Assess compliance with new policy

Methods
The proportion of individuals willing to adhere to the policy and the proportion who actually adhered were retrospectively assessed.

Results
From 2020 to 2025, 1,606 individuals were nominated (or self-nominated) for 12 ASH panels; of these, 789 completed a vetting survey assessing eligibility. In the survey, 80% agreed they could adhere to the policy (122 for X = $5,000; 667 for X = $7,500). Of the 271 appointed to a panel, 99% actually adhered; 4 were dismissed because they were unable to adhere.

Discussion
Using an aggregate annual threshold reduced the administrative burden of judging the relevance of direct financial relationships and avoided inter-panel resentment about unfairness.

Background: Post COVID-19 Condition (PCC), or long COVID, has affected over 3.5 million adults across Canada. In response to this, over 80 evidence-based clinical recommendations were created as part of the Canadian Guidelines for PCC. Several knowledge mobilization (KM) activities were implemented with the aim of making the guidelines accessible to multidisciplinary health professionals across Canada.

Objective: To target health professionals to build awareness, share knowledge, and inform decision-making about PCC recommendations through a co-designed and centrally coordinated KM strategy.

Methods: Four projects from Canadian institutions were selected through a review process to raise awareness and implement the guidelines to health professionals through different activities. Through national KM committee meetings, investigators were able to centrally coordinate, collaborate, and monitor progress. A framework was developed by our committee to ensure process or health outcomes were achieved. The impact of the KM initiatives targeting health professionals will be evaluated using frameworks including the RE-AIM, Moore’s, and GRADE FACE framework.

Results: Educational activities were implemented for health professionals across Canada. These included 10 CME-accredited webinars offered through the University of Saskatchewan; a training program for 153 internationally trained health professionals offered by the EBM Connect Canada network; and a Continuing Professional Development course on strategies for PCC management led by Université de Sherbrooke/McGill University. Recommendations were also disseminated through infographics, conferences, an EMR, and newsletters with a database of over 2000 subscribers.

Discussion: Results of the evaluation, including barriers and opportunities, will inform and strengthen guideline dissemination in Canada and internationally.

Background: The Agency for Care Effectiveness (ACE) oversees the development of national-level clinical guidelines (known as ACE Clinical Guidances) within the Ministry of Health, Singapore. While policymakers can propose topics for these guidelines, how they apply the guidelines remains unclear.

Objective: To identify how policymakers apply ACE Clinical Guidances and its implications for guideline development and implementation.

Methods: The team conducted nine informal in-person conversations with representatives from six divisions or entities. This approach was chosen over formal interviews or surveys due to existing collegial relationships. A flexible topic guide was used, and field notes were compiled post-conversation. Document analysis was undertaken to triangulate the findings.

Results: Guideline application varied based on policymakers’ remits, target audiences, and current priorities or policy challenges. Four key applications were identified:
1. Informing decision-making (e.g. expanding disease coverage)
2. Serving as enablers within national strategies (e.g. enhancing capability of service providers)
3. Supporting programme implementation through incorporation of guideline content into clinical materials and operational handbooks
4. Providing authoritative references for enquiries on clinical management

Discussion for scientific abstracts: As hypothesised, guideline applications reflect the diverse nature of policy work. While the guidelines’ evidence-to-decision (EtD) framework cannot pre-empt all policy considerations, effort should be made to assess policy implications early and transparently balance them with other EtD factors. Timely policy engagement, from scoping to guideline panel discussions, increases understanding of potential applications and can inform evidence reviews. Synergies for guideline implementation could be explored for topics linked to national strategies or programmes.

Background
When GRADE users initially choose the MID as a threshold, if the point estimate falls close to the MID, they will face two challenges. The first is that rating certainty that the true effect is important or unimportant when the underlying true effect is near the MID is misleading. The second challenge is that when the confidence interval is very narrow but crosses the MID threshold rating down for imprecision becomes counterintuitive.

Objectives
In this workshop, we will discuss how GRADE users should proceed when they have chosen the MID as a threshold - and therefore plan to rate certainty in an important or unimportant effect - and the point estimate proves to be close to the MID.

Format
The workshop will comprise four sections: (1) A short presentation will introduce the problem in deciding the target of certainty rating when GRADE users initially target a MID threshold (i.e., interested in whether an important or unimportant effect is present). (2) Using a worked example, workshop leads will introduce a possible solution. (3) In the following discussions, participants will, given examples from real systematic reviews, work together to discuss what it is in which the participants will rate their certainty (i.e, how to decide the target of certainty rating when the point estimate is close to the MID). (4) In the final feedback and summary, workshop leads will summarize some take home messages.

Background:
The adoption of international guidelines in LMICs presents significant challenges, primarily due to resource constraints that hinder their implementation. Conversely, creating new ones is difficult due to limited high-quality evidence. This highlights the need for innovative approaches to bridge global standards with local realities for evidence-based, relevant guidelines.
Objective: Create contextually relevant CPGs through modified Adolopment process.
Methods:
To address this gap, the Centre for Clinical Best Practices (CCBP) was established in 2020 at Aga Khan University, Pakistan. Recognizing the need for a structured, evidence-based, and context-sensitive approach to guideline development, CCBP collaborated with the US GRADE Network to modify the GRADE Adolopment method.
The modified method begins with selecting a source guideline (SG) through the AGREE II tool and expert consensus, recommendations from the SG (including their level of evidence) are than extracted into a Table of Recommendations (TOR), followed by three columns: adopt, adapt and exclude. An expert panel reviews each recommendation, either adopting as is, excluding, or adapting recommendations based on local relevance. Adaptations with contextual changes are created using EtD tables in the GRADEPro software.
Results: 135 common disease conditions in the country were identified through a priority-setting exercise and ICD coding to ensure the CPGs were locally relevant. The innovative use of TORs streamlined the decision-making process for reviewers by focusing efforts on recommendations which were adapted, enabling a systematic and efficient approach. While the lack of local level 1 evidence was a limitation, CCBP successfully filled the gap by producing locally applicable CPGs.