The SCD Guideline Development Process

Through a partnership with the Mayo Clinic Evidence-Based Practice Center, ASH brought together 61 experts including hematologists, other clinicians, guideline development specialists, and patient representatives to develop comprehensive clinical practice guidelines for SCD. Each panel includes U.S. and international experts from multiple disciplines, such as hematology, cardiology, internal medicine, neurology, pain, pulmonology, and psychology, as well as experts in evidence synthesis and guideline development. Each panel also had one or two patient representatives, who participated equally with the medical experts throughout the entire development process.

Development of these guidelines was wholly funded by ASH, a non-profit medical specialty society that represents hematologists. Before and during appointment to the panel, individuals disclosed both financial and nonfinancial interests. Conflicts of interest were managed through panel composition, disclosure, and recusal.

Once formed, each panel conducted a brainstorming exercise to develop a list of clinical questions and patient-important outcomes of interest. Outcomes of interest rated critical by each panel and were used to inform the systematic reviews.

Researchers then conducted systematic reviews of intervention effects and searched for evidence related to baseline risks, values, preferences and costs. The panel then developed recommendations after summarizing findings within the GRADE Evidence-to-Decision (EtD) framework.

Once each panel considered the guidelines complete, they were reviewed by the ASH Executive Committee, which then provided approval for the guidelines to be submitted to Blood Advances for peer review and subsequent publication.

• ASH Clinical Practice Guidelines on Sickle Cell Disease

  In 2016, ASH initiated an effort to develop clinical practice guidelines on Sickle Cell Disease (SCD). ASH appointed sixty-one clinical experts, five methodologists and ten patient representatives to review evidence and form recommendations on SCD. The recommendations address treatment of both adult and pediatric SCD. The systematic review of evidence was led by the Mayo Clinic Evidence-Based Practice Center.