ReacciónThe first step was to conduct a review of existing guidelines. This was especially important given that the purpose of these Guidelines is to provide guidance on how to accelerate the implementation of policies and programmes to deliver evidence-based measures and services related to HIV and TB to the health workforce. The identification of relevant guidelines was conducted by the consultant team reviewing lists of WHO and ILO guidelines in consultation with the Guideline Group.
The Guideline Group commissioned a study by Elizabeth Corbett of five African countries, to inform guideline development. The methods used in the Corbett study (Corbett 2007a) are discussed in the next subsection. The GG also commissioned a preliminary literature review, which was conducted by Mark Wheeler (Wheeler 2009). In addition, the Guideline Group conducted a study of countries worldwide to ascertain information about existing national policies and programmes (Petit-Mshana et al. 2009). The methods for this survey are described in subsection 3.
For each of the draft policy statements, the list of references provided by Corbett (115 references),, Wheeler (197 references) and Yassi (152 references) were reviewed and assessed for relevancy to the questions. The evidence from this preliminary literature review (of almost 500 articles) was then further supplemented by an additional search conducted in June 2009 to ensure completeness. This added 32 articles after duplicates were removed. This supplemental search was also conducted specifically with reference to each of the statements.
The information from the preliminary literature review, along with a review of the Corbett 5-Country Study results and the multi-country national survey results to-date were presented to the Guideline Group on July 2, 2009 to further guide decisions regarding evidence gathering for the draft statements. At this meeting, the draft statements in the Concept Paper were reviewed, and the 13 preliminary statements for the draft guidelines were reduced to 12 statements, with the preliminary view that one of the statements was redundant to what was already included in the other 12. In addition, a discussion was held of the evidence supporting each of the statements, as well as each of the seven questions formulated in the Draft Guidelines, to ascertain what, if anything, introduced elements that were not already recently reviewed for existing guidelines. This discussion led to the formulation of three questions the subject of a Cochrane-style Systematic Review, and related methodological approaches.
Methods for the Systematic Review are summarized in Section 1.2.4. The results from the initial Systematic Review were incorporated into the results presented to the GG in this Synthesis Report (Yassi et al. 2009a). The GG discussed the Systematic Review and the Synthesis Report, exchanging comments between August 15ᵗʰand September 14ᵗʰ, 2009. The presentations are available on request. Through the process of small groups focusing on wording and key points, as well as plenary discussion, the statements were revised into fourteen.