Operating procedures for the editorial team of the guidelines

1. Methodology /Method of developing guides

Duodecim first carries out a systematic search of high-quality scientific literature. The information found is evaluated and summarized in the form of "evidence summaries", and is used as a basis for the development of guides. Currently, the knowledge base includes 4000 summaries of evidence related to 1000 clinical practice guidelines.


The sources used for systematic research are:

  • Cochrane Reviews
  • Joanna Briggs Institute Database of systematic reviews and evidence implementation projects
  • Africa Evidence Network
  • DynaMed Plus by EBSCO Health
  • DARE Summaries by the Centre for Reviews & Dissemination (CRD)
  • New England Journal of Medicine, JAMA, Lancet, BMJ

Evaluation de la Qualité des Recommendations

Summaries of the evidence always indicate the level of evidence, determined according to the principles of the GRADE[1] :

  •  A  = Established scientific evidence based on relevant, high-quality scientific studies with consistent results
  •  B  = Scientific presumption. At least one relevant study of high quality or several relevant studies
  •  C  = Low level of scientific evidence. At least one adequate scientific study
  •  D  = No scientific evidence. Evaluation of other information by experts

    For many of the recommendations in the clinical practice guidelines, where the quality of recommendations have not been formally evaluated with the GRADE system. In this case, they recommendations based on reference books, journal articles, and the expertise of independent experts. They are assigned the level of proof D, which is generally not notified.

The method for developing the EBM Guidelines has been accredited by the National Institute for Health and Care Excellence (NICE) on the basis of an evaluation with the AGREE[2].

[1] These levels of evidence are identical to HAS grades A, B, C. (link to https://www.has-sante.fr/portail/upload/docs/application/pdf/2013-06/etat_of_the_places_of_proof_gradation_level.pdf).


2. Updating the guidelines

Duodecim describes 4 update processes that complement each other:

Every 3 years: all guidelines are sent to the original authors.

Every 2 months : the editorial board meets to discuss a specialty or group of topics with 1 to 3 high-level experts in the field.

Ongoing : the editorial team produces and updates evidence summaries whenever new evidence is published in Cochrane reviews or other sources.

Continuously : the Austrian and Belgian editorial teams (ebpracticenet) systematically check the guides that need to be updated and return to Duodecim.

 3. Editorial independence

Duodecim Medical Publications Ltd is 100% owned by the Finnish Medical Society Duodecim, the scientific society of Finnish doctors.

Funding comes from license fees and subscriptions to the knowledge base. Funding is not dependent on any organization or stakeholder, and the drafting teams are completely independent.

In accordance with international principles of transparency, all authors of the guides are required to disclose financial and other material conflicts of interest from the previous three years, using the International Committee of Medical Writers (ICMJE) form.

Evidence guides and summaries are developed through a transparent process.

4. Translation of the guidelines into French

Duodecim's updates are periodically sent to IVS, who translates them into French.

5. Adaptation of the African platform

We selected 4 relevant conditions, Malaria, Tuberculosis, HIV/AIDS and Hypertension for this stage. We searched available national guidelines and WHO guidelines for these conditions that were evidence based. We enriched this with evidence summaries systematically and rigorously developed from best available evidence with considerations for feasibility, appropriateness, meaningfulness and effectiveness.

The site ebmafrica.net puts guidelines from ministries of health and WHO and contextualized by countries

The ebmafrica.net site puts Duodecim's clinical practice guidelines online, adapted by countries and translated into French.

The editorial team will take into account user feedback to improve the content and ergonomics of the site.