Clinical questions should address all the areas covered
in the scope, and should avoid introducing new aspects not specified
in the scope. They will, however, contain more detail than the scope,
and should be seen as building on the fundamental framework of the guideline
as laid out in the scope. The questions are usually drafted by the technical
experts. They should then be refined and agreed by all GDG members through
discussions. The different perspectives of GDG members ensure that the
right questions are identified, thus enabling the literature search to
be planned efficiently. Often, however, the main questions need refining
once the evidence has been searched, and this may generate subquestions
(see Chapter 6). Questions may also be submitted by stakeholders for
the GDG to consider. The GDG should be explicit about the rationale it
uses for selecting questions and should keep a detailed record of the
proceedings leading to the decisions made.
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At the start of each guideline
development project, the guideline group break down the guideline remit
into structured key questions. These questions form the starting point
for the systematic literature review and it is therefore important that
they are as clear and focused as possible, defining the target population,
the intervention or exposure, the outcome, and form of comparison (e.g.
with standard treatment or between alternative new therapies).
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