8.1 Introduction

SIGN is a collaborative network of clinicians, other health care professionals and patient organisations, funded by the Clinical Resource and Audit Group (CRAG) of the Scottish Executive Health Department. SIGN guidelines are developed using a standard methodology, based on a systematic review of the evidence. Further details about SIGN guideline development methodology are contained in SIGN 50: A guideline developer's handbook.

8.2 The guideline development group

Dr Jo Davis (Chairman), Consultant in Oncology and Gynaecology, Stobhill Hospital, Glasgow
Dr Robbie Foy (Methodologist), MRC / CSO Training Fellow, Scottish Programme for Clinical Effectiveness in Reproductive Health (SPCERH)
Dr Simon Crawford (Secretary), Specialist Registrar in Obstetrics and Gynaecology, Stobhill Hospital, Glasgow
Dr Alison Bigrigg, Director, Glasgow Centre of Family Planning and Sexual Health
Dr Lucy Caird, Consultant Gynaecologist, Raigmore Hospital, Inverness
Professor Hilary Critchley, Consultant Gynaecologist and Professor of Reproductive Medicine, Royal Infirmary, Edinburgh
Dr Heather Deans, Consultant Radiologist, Aberdeen Royal Infirmary
Dr Eleanor Guthrie, General Practitioner, Scotstoun
Mr Robin Harbour, Quality and Information Director, SIGN
Sister Jacqueline McConville, Practice Nurse, Hamilton
Dr Rod Muir, Consultant in Public Health Medicine, Information and Statistics Division, Edinburgh
Dr Moray Nairn, Programme Manager, SIGN
Dr Shelagh Neil, General Practitioner, New Galloway, Castle Douglas
Mrs Winnie Sherry, Patient Representative, Motherwell
Dr Sara Twaddle, Health Economist, North Glasgow University Hospitals NHS Trust
Mrs Pamela Warner Medical Statistician, Medical Statistics Unit, University of Edinburgh

The membership of the guideline development group was confirmed following consultation with the member organisations of SIGN. Declarations of interests were made by all members of the guideline development group. Further details are available from the SIGN Executive.

8.3 Systematic literature review

The evidence base for this guideline was synthesised in accordance with SIGN methodology. A systematic review of the literature was carried out using an explicit search strategy devised by the SIGN Information Officer in collaboration with members of the guideline development group.

Searches were restricted to systematic reviews, meta-analyses, randomised controlled trials, and longitudinal studies. Internet searches were carried out on the Web sites of the Canadian Practice Guidelines Infobase, the UK Health Technology Assessment Programme, the US National Guidelines Clearinghouse, and the US National Institutes of Health. Searches were also carried out on the search engines Northern Light and OMNI, and all suitable links followed up. Database searches were carried out on Cochrane Library, Embase 1985 - May 1999, Healthstar 1975 - May 1999, and Medline 1966 - May 1999. Search strategies were reviewed by an independent information specialist. The Medline version of the search strategy can be viewed on the SIGN web site.

The main searches were supplemented by material identified by individual members of the development group and were updated in the course of development. All selected papers were evaluated using standard methodological checklists before conclusions were considered as evidence.

8.4 Consultation and peer review

A national open meeting is the main consultative phase of SIGN guideline development at which the guideline development group present their draft recommendations for the first time. The national open meeting for this guideline was held on 12 May 2000 attended by representatives of all key specialties. The draft guideline was also available on the SIGN web site for a limited period at this stage to allow those unable to attend the meeting to contribute to the development of the guideline.

8.4.1 SPECIALIST REVIEWERS INVITED TO COMMENT ON THIS DRAFT

The guideline was also reviewed in draft form by the following independent expert referees, who were asked to comment primarily on the comprehensiveness and accuracy of interpretation of the evidence base supporting the recommendations in the guideline. SIGN is very grateful to all of these experts for their contribution to the guideline.

Dr Jim Beattie, General Practitioner, Inverurie
Dr Sarah Chambers, Consultant Radiologist, New Royal Infirmary of Edinburgh
Mr Patrick Chien, Senior Lecturer, Dept of Obstetrics & Gynaecology, Ninewells Hospital, Dundee
Mr Bernard Croal, Senior Clinical Research Fellow, Dept of Pathology, Aberdeen Royal Infirmary
Dr Heather Currie, Associate Specialist Gynaecologist, Dumfries & Galloway Royal Infirmary
Dr Graham Ellis, Principal Biochemist, Dept of Clinical Biochemistry, St. John's Hospital, Livingstone
Dr Anna Glasier, Director, Family Planning & Well Woman Services, Edinburgh
Dr Martha Hickey, Division of Paediatrics, Obstetrics & Gynaecology, Faculty of Medicine, Imperial College, London
Dr Jennifer Higham, Division of Paediatrics, Obstetrics & Gynaecology, Faculty of Medicine, Imperial College, London
Dr Ruth Holman, Consultant in Sexual & Reproductive Health Care, Ayrshire Central Hospital
Dr Jo McHugo, Consultant Radiologist, Birmingham Women's Hospital
Dr Allan Merry, General Practitioner, Ardrossan
Dr Dorothy Moir, Director of Public Health, Lanarkshire Health Board
Ms Nicola Ring, Nurse Co-ordinator, Stirling University
Dr Allan Stevenson, Consultant Radiologist, Western General Hospital, Edinburgh
Dr Mike Weston, Consultant Radiologist, St James Hospital, Leeds

8.4.2 SIGN EDITORIAL GROUP

As a final quality control check, the guideline was reviewed by an Editorial Group comprising the relevant specialty representatives on SIGN Council to ensure that the peer reviewers' comments had been addressed adequately and that any risk of bias in the guideline development process as a whole had been minimised. The Editorial Group for this guideline was as follows:

Dr Doreen Campbell, CRAG Secretariat, Scottish Executive Department of Health
Dr Grahame Howard, Royal College of Radiologists - Faculty of Clinical Oncology
Ms Juliet Miller, Editor
Dr Lesley MacDonald, Faculty of Public Health Medicine
Dr Gillian Penney, Royal College of Obstetricians and Gynaecologists
Professor Joanna Wardlaw, Royal College of Radiologists - Faculty of Radiology
Dr Bernice West, National Nursing, Midwifery and Health Visiting Advisory Committee, Scotland