2023 年 40 巻 4 号 p. 499-502
To be clarified as trustworthy guidelines, it is desirable to adopt the GRADE approach which recognized the international standard. It includes that a transparent structure of the developing organization, adequate management of conflict of interest of participating members, and strict developing process. The guideline executive committee of Japanese Society of Neurological Therapeutics decided to update the Restless legs syndrome (RLS) clinical practice guidelines along “Minds clinical practice guidelines developing manual 2020 ver.3.0” (Minds manual 2020). A guideline developing group and systematic review teams were organized from July, 2021 and the seminar to learn GRADE approach was held for them.
A chairperson was elected after the COI management by the responsible society. Members were able to share the developing policy of RLS clinical practice guidelines by developing a scope beforehand. Clinical questions from important clinical topics were established, and then systematic reviews were performed using foreground questions. A process of systematic review and developing recommendation were proceeded using Minds templates. When future research questions that no studies were extracted by comprehensive literature retrieval using clinical questions, it should be emphasized that the society organized preferential research themes for the future guidelines’ revision and promoted creation of the evidence. In addition, when there is only indirect evidence in the medical practice, good practice statements (GPSs) could be adopted, however, both systematic review and recommendation were not necessary. This paper draws that the GRADE approach is useful at developing of clinical practice guidelines in the rare disease with few evidences.
