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• W2041258241 abstract "Standards and guidance for developing trustworthy clinical practice guidelines are now available, and a number of leading guidelines adhere to the key standards. Even current trustworthy guidelines, however, generally suffer from a cumbersome development process, suboptimal presentation formats, inefficient dissemination to clinicians at the point of care, high risk of becoming quickly outdated, and suboptimal facilitation of shared decision-making with patients. To address these limitations, we have—in our innovative research program and nonprofit organization, MAGIC (Making GRADE the Irresistible Choice)—constructed a conceptual framework and tools to facilitate the creation, dissemination, and dynamic updating of trustworthy guidelines. We have developed an online application that constitutes an authoring and publication platform that allows guideline content to be written and structured in a database, published directly on our web platform or exported in a computer-interpretable language (eg, XML) enabling dissemination through a wide range of outputs that include electronic medical record systems, web portals, and applications for smartphones/tablets. Modifications in guidelines, such as recommendation updates, will lead to automatic alterations in these outputs with minimal additional labor for guideline authors and publishers, greatly facilitating dynamic updating of guidelines. Semiautomated creation of a new generation of decision aids linked to guideline recommendations should facilitate face-to-face shared decision-making in the clinical encounter. We invite guideline organizations to partner with us (www.magicproject.org) to apply and further improve the tools for their purposes. This work will result in clinical practice guidelines that we cannot only trust, but also easily share and use. Standards and guidance for developing trustworthy clinical practice guidelines are now available, and a number of leading guidelines adhere to the key standards. Even current trustworthy guidelines, however, generally suffer from a cumbersome development process, suboptimal presentation formats, inefficient dissemination to clinicians at the point of care, high risk of becoming quickly outdated, and suboptimal facilitation of shared decision-making with patients. To address these limitations, we have—in our innovative research program and nonprofit organization, MAGIC (Making GRADE the Irresistible Choice)—constructed a conceptual framework and tools to facilitate the creation, dissemination, and dynamic updating of trustworthy guidelines. We have developed an online application that constitutes an authoring and publication platform that allows guideline content to be written and structured in a database, published directly on our web platform or exported in a computer-interpretable language (eg, XML) enabling dissemination through a wide range of outputs that include electronic medical record systems, web portals, and applications for smartphones/tablets. Modifications in guidelines, such as recommendation updates, will lead to automatic alterations in these outputs with minimal additional labor for guideline authors and publishers, greatly facilitating dynamic updating of guidelines. Semiautomated creation of a new generation of decision aids linked to guideline recommendations should facilitate face-to-face shared decision-making in the clinical encounter. We invite guideline organizations to partner with us (www.magicproject.org) to apply and further improve the tools for their purposes. This work will result in clinical practice guidelines that we cannot only trust, but also easily share and use. American College of Chest Physicians Antithrombotic Therapy and the Prevention of Thrombosis, 9th Edition: American College of Chest Physicians Evidence-Based Guidelines clinical decision support system decision aid Developing and Evaluating Communication Strategies to Support Informed Decisions and Practice Based on Evidence electronic medical record Grading of Recommendations Assessment, Development and Evaluation Making GRADE the Irresistible Choice population, intervention, comparator, outcomes summary of findings To succeed in evidence-based diagnosis and treatment at the point of care, health-care personnel need access to trustworthy clinical practice guidelines.1Laine C Taichman DB Mulrow C Trustworthy clinical guidelines.Ann Intern Med. 2011; 154: 774-775Crossref PubMed Scopus (82) Google Scholar The last decade has seen major advances in the science of creating clinical practice guidelines, including rigorous standards for development and tools to assess their methodologic rigor and transparency.1Laine C Taichman DB Mulrow C Trustworthy clinical guidelines.Ann Intern Med. 2011; 154: 774-775Crossref PubMed Scopus (82) Google Scholar, 2Qaseem A Forland F Macbeth F Ollenschläger G Phillips S van der Wees P Board of Trustees of the Guidelines International Network Guidelines International Network: toward international standards for clinical practice guidelines.Ann Intern Med. 2012; 156: 525-531Crossref PubMed Scopus (535) Google Scholar, 3Schünemann HJ Cook D Guyatt G American College of Chest Physicians Methodology for antithrombotic and thrombolytic therapy guideline development: American College of Chest Physicians evidence-based clinical practice guidelines (8th Edition).Chest. 2008; 133: 113S-122SAbstract Full Text Full Text PDF PubMed Scopus (35) Google Scholar Advances in approaches to summarize evidence, rate its quality, and move in a transparent manner from evidence to recommendations include the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.4Guyatt GH Oxman AD Vist GE GRADE Working Group et al.GRADE: an emerging consensus on rating quality of evidence and strength of recommendations.BMJ. 2008; 336: 924-926Crossref PubMed Google Scholar, 5Guyatt GH Oxman AD Schünemann HJ Tugwell P Knottnerus A GRADE guidelines: a new series of articles in the Journal of Clinical Epidemiology.J Clin Epidemiol. 2011; 64: 380-382Abstract Full Text Full Text PDF PubMed Scopus (1589) Google Scholar GRADE has become an international standard, adopted by > 70 organizations worldwide, providing a framework and detailed guidance for producing trustworthy guidelines.6Guyatt GH Vandvik PO Creating clinical practice guidelines: problems and solutions.Chest. 2013; 144: 365-367Abstract Full Text Full Text PDF PubMed Scopus (15) Google ScholarDespite this progress, challenges remain (Table 1). The process of producing, disseminating, and updating trustworthy guidelines remains ponderous. As a result, continuous or even timely updating is seldom undertaken; in rapidly evolving fields, guidelines become outdated quickly.7Alonso-Coello P Martínez García L Carrasco JM Solà I Qureshi S Burgers JS Updating Guidelines Working Group The updating of clinical practice guidelines: insights from an international survey.Implement Sci. 2011; 6: 107Crossref PubMed Scopus (56) Google Scholar, 8Martínez García L Arévalo-Rodríguez I Solà I Haynes RB Vandvik PO Alonso-Coello P Updating Guidelines Working Group Strategies for monitoring and updating clinical practice guidelines: a systematic review.Implement Sci. 2012; 7: 109Crossref PubMed Scopus (37) Google Scholar Moreover, the accessibility of guidelines for clinicians at the point of care is limited. Clinicians typically need to find answers to their clinical questions within 2 min, and most such questions are likely to remain unanswered if clinicians need to track down and scroll through PDF files.9Ely JW Osheroff JA Ebell MH et al.Analysis of questions asked by family doctors regarding patient care.BMJ. 1999; 319: 358-361Crossref PubMed Scopus (408) Google Scholar, 10Green ML Ciampi MA Ellis PJ Residents' medical information needs in clinic: are they being met?.Am J Med. 2000; 109: 218-223Abstract Full Text Full Text PDF PubMed Scopus (135) Google Scholar Once accessed, the user-friendliness of current presentation formats is also limited and they do not optimally facilitate the shared decision-making that is increasingly recognized as a key part of optimal clinical care.11Treweek S Oxman AD Alderson P DECIDE Consortium et al.Developing and evaluating communication strategies to support informed decisions and practice based on evidence (DECIDE): protocol and preliminary results.Implement Sci. 2013; 8: 6Crossref PubMed Scopus (142) Google Scholar, 12Stiggelbout AM Van der Weijden T De Wit MP et al.Shared decision making: really putting patients at the centre of healthcare.BMJ. 2012; 344: e256Crossref PubMed Scopus (573) Google ScholarTable 1Problems in Creating, Disseminating, and Updating Guidelines and Solutions Proposed in MAGICWhat Is the Problem?Possible Solutions 1.Lacking trustworthiness of guidelinesGuideline-authoring platform that facilitates adherence to standards for trustworthy guidelines and use of the GRADE system 2.Inefficient guideline authoring, adaptation, and dynamic updatingOnline guideline-authoring and publication platform 3.Inefficient guideline dissemination to clinicians at the point of careStructured and tagged content created in an online authoring and publication platform to allow dissemination in a wide range of devices: web platforms, applications for tablets and smartphones, and integration in EMRs 4.Suboptimal presentation formats of guideline contentMultilayered guideline content in presentation formats that meet clinicians' information needs at the point of care 5.Inconsistent and underdeveloped systems for integration of trustworthy guidelines in EMRsCDSSs customized to current standards for trustworthy guidelines (eg, both strong and weak recommendations) 6.Limited support for shared decision-making at point of careElectronic DAs, linked to recommendations in guidelines, for use by clinicians and patients in consultationsCDSS = clinical decision support system; DA = decision aid; EMR = electronic medical record; GRADE = Grading of Recommendations Assessment, Development and Evaluation; MAGIC = Making GRADE the Irresistible Choice. Open table in a new tab The inconsistency and underdeveloped integration of guidelines with patient-specific data in the electronic medical record (EMR) also limit their accessibility.13Bright TJ Wong A Dhurjati R et al.Effect of clinical decision-support systems: a systematic review.Ann Intern Med. 2012; 157: 29-43Crossref PubMed Scopus (672) Google Scholar GRADE classifies recommendations as strong when virtually all informed patients would choose the recommended management strategy. Weak recommendations—which reflect a close call between benefits and harms, uncertainty regarding treatment effects, questionable cost-effectiveness, or variability in values and preferences—apply when fully informed patients would choose different management strategies.14Guyatt GH Norris SL Schulman S et al.Methodology for the development of antithrombotic therapy and prevention of thrombosis guidelines: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines.Chest. 2012; 141: 53S-70SAbstract Full Text Full Text PDF PubMed Scopus (207) Google Scholar Traditional clinical decision support systems (CDSSs) incorporated in EMRs have not only largely ignored current standards for trustworthy guidelines but also their algorithmic “one size fits all” approaches cannot accommodate weak recommendations in which optimal management will differ between patients.A Potential SolutionIn this article, we describe the conceptual framework and tools created in an innovative research program, the objective of which is to address problems in development, dissemination, and updating of trustworthy clinical practice guidelines (Table 1). The research program, Making GRADE the Irresistible Choice (MAGIC), is conducted by a multidisciplinary team of guideline developers, clinicians, methodologists, interaction designers, and programmers in close collaboration with the GRADE working group (www.gradeworkinggroup.org/society/) and the research project Developing and Evaluating Communication Strategies to Support Informed Decisions and Practice Based on Evidence (DECIDE) (www.decide-collaboration.eu).11Treweek S Oxman AD Alderson P DECIDE Consortium et al.Developing and evaluating communication strategies to support informed decisions and practice based on evidence (DECIDE): protocol and preliminary results.Implement Sci. 2013; 8: 6Crossref PubMed Scopus (142) Google Scholar DECIDE is a European Union-funded project, the goal of which is to improve communication strategies for evidence-based recommendations directed at health-care providers, patients and the public, and policymakers. To establish formal collaboration with organizations interested in applying and further developing our tools for their own purposes, we have established MAGIC as a nonprofit organization (www.magicproject.org). Our conceptual framework is grounded in the GRADE system and mirrors insights addressing effective implementation of guidelines and optimal use of decision support systems (http://www.healthit.gov/policy-researchers-implementers/meaningful-use).15Gagliardi AR Brouwers MC Palda VA Lemieux-Charles L Grimshaw JM How can we improve guideline use? A conceptual framework of implementability.Implement Sci. 2011; 6: 26Crossref PubMed Scopus (289) Google Scholar, 16Digital Government Building a 21st century platform to better serve. the American people. The White House website.http://www.whitehouse.gov/sites/default/files/omb/egov/digital-government/digital-government.htmlDate: 2012Google ScholarWe are in the process of implementing our tools in the context of a national guideline for antithrombotic therapy in Norway. The resulting guideline would to a large extent be adapted from the recently published ninth iteration of the American College of Chest Physicians (ACCP) antithrombotic guidelines (Antithrombotic Therapy and the Prevention of Thrombosis, 9th Edition: American College of Chest Physicians Evidence-Based Guidelines [AT9]).17Guyatt GH Akl EA Crowther M Gutterman DD Schuunemann HJ Executive summary: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines.Chest. 2012; 141: 7S-47SAbstract Full Text Full Text PDF PubMed Scopus (1357) Google Scholar We consider AT9 as well suited for this purpose as it complies with standards for trustworthy guidelines and was published in a traditional PDF format.14Guyatt GH Norris SL Schulman S et al.Methodology for the development of antithrombotic therapy and prevention of thrombosis guidelines: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines.Chest. 2012; 141: 53S-70SAbstract Full Text Full Text PDF PubMed Scopus (207) Google Scholar Figure 1 illustrates how the AT9 guideline would be transformed into the new multilayered guideline format. In this article, we also provide examples of how the new guideline format will look in the Norwegian guideline, based on content from one of the AT9 chapters being used and incorporated with the permission of the ACCP.18Falck-Ytter Y Francis CW Johanson NA et al.Prevention of VTE in orthopedic surgery patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines.Chest. 2012; 141: e278S-e325SAbstract Full Text Full Text PDF PubMed Scopus (1521) Google ScholarFigure 2 outlines our conceptual framework to facilitate the authoring, dissemination, and dynamic updating of trustworthy guidelines. To reach these objectives, we have created an online application that constitutes a guideline-authoring and publication platform (MAGIC application software). Through the use of “chunks” of information (analogous to Lego blocks), the platform allows creation of multilayered electronic guidelines, publishing in user-friendly formats on the web and in smartphones and tablets, creation of decision aids (DAs), and integration with EMRs. In the subsequent discussion we provide the requirements and functionalities of our tools and how they have been developed.Figure 2Conceptual framework, authoring and publication platform, and guideline outputs. App = application software; EBM = evidence-based medicine; EMR = electronic medical record; MAGIC = Making GRADE the Irresistible Choice; PICO = population, intervention, comparator, outcomes. See Figure 1 legend for expansion of other abbreviations. (Illustrated with content from an AT9 chapter. Adapted with permission from Falck-Ytter et al.18Falck-Ytter Y Francis CW Johanson NA et al.Prevention of VTE in orthopedic surgery patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines.Chest. 2012; 141: e278S-e325SAbstract Full Text Full Text PDF PubMed Scopus (1521) Google Scholar)View Large Image Figure ViewerDownload Hi-res image Download (PPT)Online Guideline-Authoring and Publication PlatformWe have identified the following functionalities to facilitate the guideline-authoring and publication process: (1) delineation of clinical questions in a structured and standardized format,19Guyatt GH Oxman AD Kunz R et al.GRADE guidelines: 2. Framing the question and deciding on important outcomes.J Clin Epidemiol. 2011; 64: 395-400Abstract Full Text Full Text PDF PubMed Scopus (1106) Google Scholar (2) facilitated identification and appraisal of the best current research evidence,20Guyatt G Oxman AD Sultan S et al.GRADE guidelines: 11. Making an overall rating of confidence in effect estimates for a single outcome and for all outcomes.J Clin Epidemiol. 2013; 66: 151-157Abstract Full Text Full Text PDF PubMed Scopus (474) Google Scholar (3) consideration and judgment of key factors when moving from evidence to recommendations,21Guyatt GH Oxman AD Kunz R GRADE Working Group et al.Going from evidence to recommendations.BMJ. 2008; 336: 1049-1051Crossref PubMed Google Scholar (4) development of recommendations, underlying key information and rationale in flexible presentation formats,22Guyatt G Oxman AD Akl EA et al.GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables.J Clin Epidemiol. 2011; 64: 383-394Abstract Full Text Full Text PDF PubMed Scopus (4715) Google Scholar (5) automatic translation and publication of these formats into presentations for clinicians and DAs to facilitate shared decision-making, (6) development of structured content for EMRs, and (7) linkage to resources such as risk calculators and social media. Existing guideline-authoring tools and publication platforms have developed some but not all of these functionalities and are not structured to take full advantage of GRADE.23Shiffman RN Michel G Rosenfeld RM Davidson C Building better guidelines with BRIDGE-Wiz: development and evaluation of a software assistant to promote clarity, transparency, and implementability.J Am Med Inform Assoc. 2012; 19: 94-101Crossref PubMed Scopus (139) Google ScholarTo accomplish objectives in MAGIC, we have developed an online application that constitutes an authoring and publication platform that allows guideline content to be written and structured in a database, published directly on our web platform, or exported in a computer-interpretable language (eg, XML), enabling dissemination through a wide range of outputs that include EMR systems, web portals, and applications for smartphones/tablets. Modifications in guidelines, such as recommendation updates, will lead to automatic alterations in these outputs (eg, update of guidelines on the web or in smartphone applications) with minimal additional labor for guideline authors and publishers, greatly facilitating dynamic updating of guidelines.Figure 3 shows the module for linking structured questions to recommendations in the online application. The organization of content in our application is centered around structured questions, defining the population, intervention, comparator, and outcomes (PICO format). The PICO questions allow identification of the most appropriate research evidence, and the development of tables that clearly and efficiently summarize the relevant evidence.19Guyatt GH Oxman AD Kunz R et al.GRADE guidelines: 2. Framing the question and deciding on important outcomes.J Clin Epidemiol. 2011; 64: 395-400Abstract Full Text Full Text PDF PubMed Scopus (1106) Google Scholar, 22Guyatt G Oxman AD Akl EA et al.GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables.J Clin Epidemiol. 2011; 64: 383-394Abstract Full Text Full Text PDF PubMed Scopus (4715) Google Scholar The structured PICO format also allows linkage of recommendations to coding systems and taxonomies that can be used for the interaction between guidelines and the EMR. Using the application will not constitute an extra task for the guideline panel. Rather, it provides a more efficient working interface for panelists to document the key processes in guideline development.Figure 3Online guideline-authoring and publication platform showing module for selecting PICO questions relevant to recommendations. HFS = hip fracture surgery; IPCD = intermittent pneumatic compression device; LDUH = low-dose unfractionated heparin; LMWH = low-molecular-weight heparin; PE = pulmonary embolism; THA = total hip arthroplasty; TKA = total knee arthroplasty; VKA = vitamin K antagonist. See Figure 1, Figure 2 legends for expansion of other abbreviations. (Exemplified with content from an AT9 chapter. Adapted with permission from Falck-Ytter et al.18Falck-Ytter Y Francis CW Johanson NA et al.Prevention of VTE in orthopedic surgery patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines.Chest. 2012; 141: e278S-e325SAbstract Full Text Full Text PDF PubMed Scopus (1521) Google Scholar)View Large Image Figure ViewerDownload Hi-res image Download (PPT)Multilayered GuidelinesImproving guideline use in daily practice requires presentation formats adapted to clinicians' needs and constraints. During a hectic workday, clinicians want immediate access to short and actionable recommendations. At other times, they require progressively more detailed information to tailor management to the individual patient.Figure 4 shows the electronic multilayered approach tailored to these varied demands. This format represents a restructuring of the information already provided in trustworthy guidelines. Adapting original publications into the new presentation format has proven easier than expected during our development process.Figure 4A, Top layer of the guideline displaying recommendations. B, Key information section, one click away from the recommendation. See Figure 3 legend for expansion of abbreviations. (Both panels include content from an AT9 chapter, transformed into the new format. Adapted with permission from Falck-Ytter et al.18Falck-Ytter Y Francis CW Johanson NA et al.Prevention of VTE in orthopedic surgery patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines.Chest. 2012; 141: e278S-e325SAbstract Full Text Full Text PDF PubMed Scopus (1521) Google Scholar)View Large Image Figure ViewerDownload Hi-res image Download (PPT)In the multilayered approach, we first provide the recommendations together with the strength of the recommendation (Fig 4A) having the more in-depth information “hidden” behind (eg, short narrative text with key information in Fig 4B). We have dubbed this approach “the top layer format,” defined as the minimum set of information components necessary for a health-care professional to act on the recommendation when dealing with an individual patient. The format reflects standards for trustworthy guidelines and GRADE methodology, providing the end user with brief narrative information addressing the key components that the guideline panels consider when moving from evidence to recommendation (ie, the balance between benefits and harms, quality of the evidence, typical preferences and values and, sometimes, resource use) in addition to a free text rationale for the recommendation (Fig 4B).Guideline users will sometimes require access to more comprehensive information. Figure 5 shows a summary of findings (SoF) table available one click away from the top layer. The SoF table provides effect estimates and confidence in those estimates, with the possibility of graphical presentations of statistical data as currently being developed in the DECIDE project.11Treweek S Oxman AD Alderson P DECIDE Consortium et al.Developing and evaluating communication strategies to support informed decisions and practice based on evidence (DECIDE): protocol and preliminary results.Implement Sci. 2013; 8: 6Crossref PubMed Scopus (142) Google Scholar, 22Guyatt G Oxman AD Akl EA et al.GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables.J Clin Epidemiol. 2011; 64: 383-394Abstract Full Text Full Text PDF PubMed Scopus (4715) Google Scholar In the deeper layers, guideline users can also find extensive narrative summaries of the evidence, original articles, and practical information (eg, calculators, dosage, contraindications).Figure 5Summary of findings (SoF) table available in deeper layers.View Large Image Figure ViewerDownload Hi-res image Download (PPT)Research concerning presentation formats is conducted within the DECIDE project using an iterative process with brainstorming, user testing with guideline users, and stakeholder feedback. Subsequent developments will include trials investigating alternative presentation formats, allowing testing of navigational issues, user-friendliness, comprehension, and accessibility of information at the point of care.11Treweek S Oxman AD Alderson P DECIDE Consortium et al.Developing and evaluating communication strategies to support informed decisions and practice based on evidence (DECIDE): protocol and preliminary results.Implement Sci. 2013; 8: 6Crossref PubMed Scopus (142) Google ScholarIntegration of Guidelines in EMRsThe adequate use of weak or conditional recommendations as part of a CDSS requires an approach that differs from the traditional algorithmic if-then relationship. Such if-then algorithms build on the assumption that patients will fit into categories in which a particular course of action is correct for one clearly definable category of patients and wrong for all others. This may be true for strong recommendations, but for weak recommendations in which the optimal course of action differs for patients with similar characteristics, it is clearly not. MAGIC will facilitate a CDSS suitable for weak recommendations allowing a certain degree of personalization.The first part of our approach to integration of guidelines in EMRs, connection of patient-specific information, will make it possible for the EMR system to show relevant clinical items from the patient whose chart is open alongside the recommendation in question. The guideline-authoring tool will allow guideline authors to select these relevant clinical items (diagnoses, laboratory tests, conditions, medications) specific to each recommendation. The clinical items will not be chosen to strictly define patients in whom the recommendations do or do not apply, and therefore will have no threshold values and will elicit no alarms. Rather, they will provide information for the clinician to individualize application of the recommendations. This approach relies on the superior contextual processing skills of clinicians to make balanced clinical judgments supported by guideline recommendations.The second aspect of our approach to EMRs addresses not only the need of clinicians to rapidly find answers to their questions, but also the delivery of recommendations that clinicians were not specifically seeking. We will achieve these objectives by allowing tagging of the backbone of the guidelines, the structured clinical questions (PICOs), to elements from clinical ontologies and taxonomies (eg, International Classification of Diseases and Related Health Problems, 10th edition; Systematized Nomenclature of Medicine-Clinical Terms; Anatomical Therapeutic Chemical Classification System; and, MeSH). This would, for example, allow for matching of the patient problem list to relevant recommendations, and offer placement of suggested drug orders. The PICO coding could also be matched to information from other kinds of software outside the EMR, like drug catalogs and knowledge repositories. Providing such high-level interactions between the guideline and the EMR, as opposed to more low-level hardcoding of decision-support algorithms into every single EMR system, will greatly facilitate maintenance and updating of the CDSS. Dynamically updated content in the central guideline repository will appear in the guidelines in the EMR without requiring new and laborious roun" @default.
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• W2041258241 title "Creating Clinical Practice Guidelines We Can Trust, Use, and Share" @default.
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• W2041258241 cites W2028409057 @default.
• W2041258241 cites W2061131082 @default.
• W2041258241 cites W2064010848 @default.
• W2041258241 cites W2073924861 @default.
• W2041258241 cites W2080994524 @default.
• W2041258241 cites W2093770528 @default.
• W2041258241 cites W2101702919 @default.
• W2041258241 cites W2104675861 @default.
• W2041258241 cites W2106707960 @default.
• W2041258241 cites W2107021177 @default.
• W2041258241 cites W2112190129 @default.
• W2041258241 cites W2113354881 @default.
• W2041258241 cites W2118115713 @default.
• W2041258241 cites W2136403658 @default.
• W2041258241 cites W2151925786 @default.
• W2041258241 cites W2156668289 @default.
• W2041258241 cites W2162138305 @default.
• W2041258241 cites W2164762515 @default.
• W2041258241 cites W2165010366 @default.
• W2041258241 cites W2169569461 @default.
• W2041258241 cites W2201429547 @default.
• W2041258241 cites W2328498025 @default.
• W2041258241 cites W3016782834 @default.
• W2041258241 cites W4246717522 @default.
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