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an Economist Intelligence Unit business healthcare

Quality Assurance of Australian NHMRC Guidelines

January 7th 2011

We’ve always dreamt here at Bazian of one day having an office down under. The climate seems so attractive for one thing, particularly when sitting here writing this news story on a grey wintry afternoon in London… So while perhaps we’re no nearer a new office, we are delighted to have the opportunity to be involved in some work for the NHMRC: Australia’s National Health and Medical Research Council.

We’re working with Catherine Marshall, an independent guideline adviser and health consultant from the beautiful Hawkes Bay region of New Zealand and Dr Jan Davies, previously executive director at the National Institute of Clinical Studies in Australia who’s experience lies in implementation and closing those all important ‘evidence practice gaps’. The aim is to ensure that guidelines approved by the NHMRC meet the quality criteria they set. We work together to provide an assessment report and assign ratings against the “Evidence Review” and “Guideline recommendations” sections, as checked against the criteria listed in the Procedures and requirements for meeting the NHMRC standard for clinical practice guidelines. All this has to be done within 20 working days of us receiving the guideline, and some of the guidelines with their supporting evidence reviews are together over 1000 pages in length…

In Australia, guidelines are produced by a range of organisations using different methodologies and standards. Research also shows that guidelines are consistently underused in practice. NHMRC has this year published a national study of clinical practice guidelines which has identified over 80 organisations producing guidelines, up from 32 in 1993. The paper coined the phrase “evidence-documented” to mean those guidelines that had as a minimum, a brief description of a literature review with some specific details of the search and appraisal process; 91/313 (29%) passed this test for evidence-documentation. Clearly Quality Assurance is an important endeavour, and approval of guidelines by the NHMRC should help to get the best quality ones used in practice.

One of the reasons why we’re able to turn this work around quickly and reliably is because of the division of labour. When we’re at work on the documents here, our Australian and New Zealand partners can take a well-earned rest, and vice-versa. The potential advantages are evident, particularly for clients who need things done within a short turn-around time, and hopefully we’ll be able to utilise this round-the-clock model of working for other projects when suitable.

So there we have it; no office yet, but the Antipodean sunshine no longer feels quite so far away…