The conceptual framework used to guide the identification, selection, development and updating of the Canadian best practice recommendations is the Practice Guideline Evaluation and Adaptation Cycle of Graham and colleagues.3This cycle involves the following steps:
- Establishing an interprofessional guideline development team
- Establishing a guideline appraisal process using a validated tool
- Systematic searching for existing practice guidelines
- Appraising the quality, currency, and content of guideline recommendations
- Adopting or adapting guidelines for local use
- Obtaining external expert feedback on the proposed recommendations
- Selecting final recommendations
- Obtaining official endorsement
- Establishing an ongoing review and update process
The methodology for the first edition of the Canadian Best Practice Recommendations for Stroke Care (2006) was based on this framework, and it is applied, with some enhancements, to develop each update.
The rest of section 2 outlines the key activities undertaken in the development process.