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3. Methodology
Methodology. Evidence levels and formulation of recommendations.
The methodology used is recorded in the “Manual de elaboración de GPC” (Manual on how to
create a Clinical Practice Guideline) from the Ministry of Health and Consumer Affairs 1 .
The steps followed were:
• Setting up the group in charge of creating the guide, which included the following professionals
from: primary care (medicine, nursing, pharmacy), specialised care (endocrinologists
and nursing educators on diabetes) and professionals experienced in the creation of a
Clinical Practice Guideline.
• Creating of clinical questions following the Patient / Intervention / Comparison / Outcome
format.
• Developing a qualitative study with diabetic patients (focal group and personal interviews)
in order to validate and complete the list of questions.
• Bibliographic review:
— Data bases: Cochrane Library, DARE, Medline Pubmed, Evidence Based Review,
Embase, CINHAL, Clinical Evidence, IME, IBECS.
— Languages: English, French and Spanish.
— Research structure: in a first phase, preliminary research of Clinical Practice Guidelines
and systematic reviews was carried out. As a secondary evidence resource, a Clinical
Practice Guideline on glycemic control 2 and specific Clinical Practice Guidelines on
retinopathy, diabetic foot and nephropathy have been included 3, 4, 5 .
— The Clinical Practice Guideline from the GEDAPS group has been used as additional
reference material. (2).
— In a second phase, wide research on original studies (randomised clinical trials, observational
studies, studies of diagnosis and prognosis tests and clinical prediction rules)
was carried out.
— Research period: the research deadline was January 2008. However, a service of bibliographic
alert was kept active until May 2008 to include the most relevant updated
literature.
1
Grupo de trabajo sobre GPC, Elaboración de Guías de Práctica Clínica en el Sistema Nacional de Salud. Manual Metodológico.
Madrid: Plan Nacional para el SNS del MSC. Instituto Aragonés de Ciencias de la Salud -I+CS; 2007. Guías de Práctica Clínica en el
SNS: I+CS Nº 2006/0I.
2
NICE. Clinical Guideline. Management of type 2 diabetes: Management of blood glucose. London: National Institute for Clinical
Excellence; 2002.
3
NICE. Clinical Guideline. Management of type 2 diabetes: Retinopathy, screening and early management. London: National
Institute for Clinical Excellence; 2002.
4
NICE. Clinical Guideline. Management of type 2 diabetes: Prevention and management of foot problems. London: National Institute
for Clinical Excellence; 2003.
5
National Institute for Clinical Excellence. Clinical Guideline F. Management of type 2 diabetes. Renal disease- prevention and early
management. London: National Institute for Clinical Excellence; 2002.
CLINICAL PRACTICE GUIDELINE ON TYPE 2 DIABETES 29