Nordic guidelines?

An idea within NFOG

Anette Tønnes Pedersen, Gyn. Klinik / Fertilitetsklinikken, Rigshospitalet

NFOG Board meeting March 2013:

NFOG initiatives for Nordic Collaboration. Possible projects were discussed in the Board: ....... Nordic guidelines or statements on issues of common interest, i.e. misoprostol and oral contraception and risk of trombosis . Registration of complications, i.e. mesh. Making guidelines on how to make guidelines (core guidelines)… suggested a coordination of the different registrations that are already established within the Nordic countries.

NFOG Board meeting September 2013:

..the question of common NFOG guidelines. In the following discussion the concern about the difficulty of agreeing on common guidelines was raised. .. The RCOG guidelines were mentioned as model guidelines.

It was suggested to establish a ”Guideline Committee” within the NFOG. The Board decided to propose for the next GA to establish a GC.

Task for a preliminary working group:

• to make an overview of existing guidelines the 5 Nordic countries

• to assess the need for Nordic collaboration on guidelines

• what format: common guidelines? Core guidelines? Guidelines for guidelines? Policy statements?

• to suggest a feasible way for further collaboration in NFOG 

Task for a preliminary working group:

to make an overview of what is already being done in the 5 Nordic countries

• to assess the need for a Nordic collaboration

• to discuss the advantages and challenges of such a Nordic collaboration

• to suggest a feasible way to establish a guidelines collaboration in NFOG 

Does your society make obstetrical / gynecological guidelines?

yes

yes

yes

(no)

no

Denmark:

• 81 obstetrical guidelines / 81 gynecological guidelines

• Since 1996 / 2001

• Published electronically on DSOG website

• Made by experts and younger colleagues

• Evidence based

• Revised every 5 years or when needed

Sweden:

• 29 obstetrical guidelines / 33 gynecological guidelines

• Since 1980

• Published in print and now also electronically on SFOG website

• Made by experts and younger colleagues

• ”State of the art” reports – not systematically evidence based

• Since 2011: SFOG riktlinje, evidence based, so far 2-3 guidelines

Norway:

• 46 obstetrical guidelines / 44 gynecological guidelines

• Since 1992

• Published electronically on NFG website

• Made by experts and younger colleagues

• Only onco-gyne evidence based

• Evidence based obstetrical guidelines in the pipeline

• Revised every 5 years or when needed

Finland:

• Guidelines published by the Finnish Medical Association

• 3 obstetrical guidelines / 9 gynecological guidelines

• Since 1998

• Published on the website and in the journal of the Finnish Medical Ass.

• Made by experts, sometimes also involving younger colleagues

• Evidence based

• Revised every 5 years

Iceland:

• No guidelines issued by the Icelandic society

• Landlæknir issued guidelines on HRT in 2004

• Landspitalinn has written guidelines for Iceland (endorsed by Landlæknir) on Gestational diabetes based on the new international guidelines. These are not graded by evidence.

• Local O&G departments in Akureyri and at Landspitalinn in Reykjavík have written in house guidelines on various topics with references but not graded according to evidence.

• These would mostly be based on international guidelines such as RCOG.

Challenges:

• Language:

- evidence and critical appraisal in English

- clinical recommendations in local language?

• Relationship to national guidelines

• Consider legal aspects

Preminary working group

• Alexander Smárason (Iceland)

• Ritva Hurskainen (Finland)

• Knut Hordnes (Norway)

• Marie Bixo (Sweden)

• Niels Uldbjerg (Denmark)

Activity

• Preliminary working group: Skype-meeting, February 24 2014 – Open discussion no decision on format– Budget for further meetings: four meetings next

two years 100.000 DKK annualy (in budget)

• First Guide Line Committee meeting – if GA support: Soria Moria, Oslo, October 9-11 2014.

Do we have the support of the GA to work further?

Important: format is open, the goal is not set, no common guidelines is also a valid conclusion