ERAS Society Policy on Guidelines

Objective: To outline the policies of the Society in relation to guideline development.

Background

Guidelines produced by the ERAS® Society are an important and central mission for the Society. They should be evidence based, uniformly formatted and used as an important framework for clinical care of the surgical patient. Given the impact of previous guidelines, this constitutes a major responsibility placed upon the Society. Therefore, the ultimate decisions about the commissioning, publication and dissemination of the guidelines will rest with the Executive Committee. Topics for new guidelines are welcome and should be addressed initially to the Chair of the Scientific Committee. All suggested topics will be presented by the Scientific Chair and considered by the full Executive Committee.

Guidelines Committee

The Executive Committee will appoint a Guideline Committee (generally n= 2 or 3). The Guideline Committee will have at least one member from the Executive Committee and one from the Scientific Committee. The Guideline Committee will report to the Scientific Committee. In the absence of suggestions from members of the
Society, the Guideline Committee will identify areas where guidelines are necessary (or need to be updated) and propose lead and senior authors. The Guideline Committee will be responsible for development of the format of guidelines, approval of the final version, decision to publish and journal of first choice. The Guideline Committee will appoint an Editor for each Guideline.

Authors and collaborators

Authors of guidelines should be experts in the field and should have published a reasonable body of original work in the area. The Executive Committee prior to start of the work should approve authorship.

To maintain uniformity, interpretation of data should be done by senior clinicians/researchers. Responsibility for grading of evidence and recommendations should rest with the first and senior authors with input from the Guideline Committee.

The target should be approximately eight to ten main authors (more when approved by Guideline Committee) plus, the Editor appointed by the Guideline Committee, followed by associates (if necessary – ERAS® working party on…………..). Associates can include junior staff, who have done systematic reviews etc.

The Society strongly supports involvement of junior academic staff in guideline development. Literature reviews are highly welcome from junior staff. These can be published as separate, independent pieces of academic work.

Guideline Editor(s) input

There may be highly variable requirements but Editors should be an author, when appropriately involved in the project.

Format of the guidelines

The format of the guidelines should be decided by the Guideline Committee to ensure uniformity and proper development over time. [See format used by Gustafsson U et al Clinical Nutrition 2012, 31, 783-800].

Labour and Time lines

Clear division of labour and timelines should be agreed among authors and the Guideline Committee, and if possible with the Publisher at the outset. Deadlines need to be clearly stated. The lead author should send regular (quarterly) updates by to the relevant Editor appointed by the Guideline Committee. Authors who do not meet deadlines will need to negotiate continuation on the guideline with the Guideline Committee.

General principles for introduction of data collection for new practice guidelines

New Guidelines should be followed by the introduction of a new area for that topic on the ERAS Society Interactive Audit (EIAS) database. For existing EIAS systems already in use, the appropriate action will often be an update of the database to match the updated guidelines. A core team including the authors of the guidelines (preferably including the first and senior author) in collaboration with the database designers should develop this introduction or update. The ERAS® Society has a contract with ENCARE AB to provide an interactive audit system which should be used (ERAS Interactive Audit System). Under the current agreement this is the official ERAS® Society audit system.

Once the database is in place, the Guideline Committee will select a co-ordinator for groups of units to record, evaluate and publish consecutive patient series.

This initial series then becomes the basis for further development and research in the domain of the guideline.

Revision of Existing Guidelines

All existing guidelines will be considered for revision by the Scientific and the Executive Committee every 3 years or earlier if appropriate.