So, what is NGC and what is the Inclusion Criteria?
NGC is an initiative of the Agency for Healthcare Research and Quality (AHRQ) External Web Site Policy, U.S. Department of Health and Human Services. NGC was originally created by AHRQ in partnership with the American Medical Association and the American Association of Health Plans (now America's Health Insurance Plans [AHIP]).
The NGC mission is to provide physicians and other health professionals, health care providers, health plans, integrated delivery systems, purchasers, and others an accessible mechanism for obtaining objective, detailed information on clinical practice guidelines and to further their dissemination, implementation, and use.
Effective June 1, 2014, NGC uses the 2011 definition of clinical practice guideline developed by the Institute of Medicine (IOM).1
Clinical practice guidelines are statements that include recommendations intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options.
2013 (Revised) Criteria for Inclusion of Clinical Practice Guidelines in NGC
Effective June 1, 2014: In order for NGC to accept a submitted clinical practice guideline, the guideline must meet all the criteria below. In addition to the guideline, developers must provide NGC with documentation of the underlying systematic review*.
The full description of the inclusion criteria is available at the above link.
https://www.guideline.gov/about/Determi ... InNGC.aspx
Will NGC have guidelines that meet two different sets of criteria (i.e., 1997 criteria versus 2013 [revised] criteria)?Determining Extent Adherence to the IOM Standards in NGC
The following information describes the Institute of Medicine (IOM) standards for trustworthy guidelines and the National Guideline Clearinghouse's (NGC's) planned activities related to the standards.
IOM Recommendation for NGC: Indicating Extent Adherence
The 2011 IOM report on trustworthy guidelines included the following recommendation:
"The Agency for Healthcare Research and Quality should…require the National Guideline Clearinghouse (NGC) to provide a clear indication of the extent to which clinical practice guidelines (CPGs) submitted adhere to the standards for trustworthiness."2
The Agency for Healthcare Research and Quality (AHRQ) is currently exploring options to determine whether and how best to meet the above recommendation. If any changes to NGC result from this exploration, they will be phased in over the next several years, and AHRQ will provide opportunities to engage stakeholders, including the NGC/NQMC Editorial Board, guideline developers, and NGC users in that effort.
NGC's Steps and Timeline
The first step has already taken place, namely the revision of NGC's Inclusion Criteria to meet the IOM's updated definition of CPGs.
"Clinical practice guidelines are statements that include recommendations intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options."2
The revised inclusion criteria were posted to the NGC Web site in June 2013 and became effective in June 2014. Guidelines submitted after June 1, 2014, must meet the 2013 (revised) inclusion criteria to be accepted into NGC.
How long will guidelines accepted under the old criteria remain in NGC?
Guidelines submitted and accepted for inclusion under the 1997 criteria will remain on the NGC site until they are revised by the developer, withdrawn by the developer, or withdrawn by NGC because they are no longer considered current (i.e., when they are ≥5 years old). As a result, there could be guidelines on NGC that were accepted under the 1997 criteria through 2019. However, it should be noted that guidelines included under the 1997 criteria could also meet the standards of the 2013 (revised) criteria.
Why are many guidelines removed from NGC at the end of the year, and how do I know whether they are going to be updated?
As part of the NGC Annual Verification, many guidelines are withdrawn from the Web site at the end of every year because they no longer meet our Inclusion Criteria with respect to date. NGC's inclusion criteria specifically require that guidelines represented in our database have been developed, reviewed, or revised within the last five years. All guidelines that no longer meet this criterion are removed from the Web site at the end of each calendar year. See the Guideline Archive for a list of withdrawn or updated summaries.
Currently when searching for Lyme disease on the NGC website 14 listings can be found. One of these is not a guideline (#10) but instead is an expert commentary about guidelines by the NGC Editorial staff. Several others seem to not be particularly related to Lyme disease, but perhaps mention it somewhere in the text. Here is the list:
Evidence assessments and guideline recommendations in Lyme disease: the clinical management of known tick bites, erythema migrans rashes and persistent disease. 2004 (revised 2014 Sep). NGC:010732
International Lyme and Associated Diseases Society - Disease Specific Society.
EFNS guidelines on the diagnosis and management of European Lyme neuroborreliosis. 2010 Jan. NGC:008323
European Academy of Neurology - Medical Specialty Society.
EFNS-ENS guidelines for the use of PCR technology for the diagnosis of infections of the nervous system. 2012 Oct. NGC:009365
European Academy of Neurology - Medical Specialty Society; European Neurological Society - Medical Specialty Society.
Evaluation of vertigo in the adult patient 2014 May. NGC:010416
University of Texas at Austin School of Nursing, Family Nurse Practitioner Program - Academic Institution.
Practice guidelines for the psychiatric evaluation of adults, third edition. 1995 (revised 2015). NGC:010779
American Psychiatric Association - Medical Specialty Society.
European Federation of Neurological Societies/Peripheral Nerve Society guideline on management of chronic inflammatory demyelinating polyradiculoneuropathy: report of a joint task force of the European Federation of Neurological Societies and the Peripheral Nerve Society – first revision. 2006 Apr (revised 2010 Mar). NGC:007904
European Academy of Neurology - Medical Specialty Society; Peripheral Nerve Society - Disease Specific Society
Late intrauterine fetal death and stillbirth. 2010 Oct. NGC:008288
Royal College of Obstetricians and Gynaecologists - Medical Specialty Society.
Clinical practice guideline: Bell's palsy. 2013 Nov. NGC:010075
American Academy of Otolaryngology - Head and Neck Surgery Foundation - Medical Specialty Society
Chronic fatigue syndrome/myalgic encephalomyelitis. A primer for clinical practitioners. 2012. NGC:009288
International Association for Chronic Fatigue Syndrome/Myalgic Encephalomyelitis - Nonprofit Organization.
expert commentary A Season for Change By: NGC Editorial Staff
Heart failure in adults. 1997 Oct (revised 2013 Jul). NGC:009982
Institute for Clinical Systems Improvement - Nonprofit Organization.
2012 ACCF/AHA/HRS focused update incorporated into the ACCF/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. 1998 Apr (revised 2013 Jan 22). NGC:009902
American College of Cardiology Foundation - Medical Specialty Society; American Heart Association - Professional Association; Heart Rhythm Society - Professional Association.
ACR Appropriateness Criteria® hearing loss and/or vertigo. 1996 (revised 2013). NGC:010159
American College of Radiology - Medical Specialty Society.
Evidence-based guideline: treatment of parenchymal neurocysticercosis. Report of the Guideline Development Subcommittee of the American Academy of Neurology. 2013 Apr 9. NGC:009788
American Academy of Neurology - Medical Specialty Society.
Here is the link to "WITHDRAWN" guidelines:
To find them on these 'withdrawn' pages click on the letter I for IDSA and these are listed as #17.The list below identifies guidelines that have been withdrawn from the NGC Web site.
Guideline summaries are removed from the NGC Web site because the guidelines they represent no longer meet the NGC Inclusion Criteria or the guideline developer indicated that the guideline should be withdrawn. Refer to the guideline developer's Web site, where available, for more information.
NGC currently contains 3668 individual guideline summaries that have been withdrawn.
17. Infectious Diseases Society of America practice guidelines for clinical assessment, treatment and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis. NGC:005085