Guideline 73 Section 8: Development of the guideline

Management of obstructive sleep apnoea/hypopnoea syndrome in adults Section 8: Development of the guideline

8.1 Introduction

SIGN is a collaborative network of clinicians and other health care professionals, funded by NHS Quality Improvement Scotland. SIGN guidelines are developed by multidisciplinary groups of practicing clinicians using a standard methodology, based on a systematic review of the evidence. Further details about SIGN and the guideline development methodology are contained in “SIGN 50; A Guideline developer’s handbook” available at www.sign.ac.uk

8.2 The guideline development group

Dr Tom Mackay (Chairman)	Consultant Respiratory Physician, Sleep Centre, Edinburgh Royal Infirmary
Dr Steve Banham	Consultant Respiratory Physician,Glasgow Royal Infirmary
Miss Alison Beattie	Senior Dietitian, Department of Nutrition and Dietetics, Perth Royal Infirmary
Dr Roger Carter	Principal Scientist, Glasgow Royal Infirmary
Dr Alistair Dorward	Consultant Physician, Royal Alexandra Hospital, Paisley
Dr Heather Engelman	Senior Research Fellow, Sleep Centre, Edinburgh Royal Infirmary
Professor Colin Espie	Clinical Psychologist, Glasgow University
Mrs Jean Gall	Chair, Scottish Association for Sleep Apnoea
Mr Robin Harbour	Quality and Information Director, SIGN
Sister Carol Hoy	Senior Specialist Sleep Nurse, Sleep Centre, Edinburgh Royal Infirmary
Dr Peter Hutchison	General Practitioner, Dumfries
Dr William Kinnear	Consultant Physician, University Hospital, Nottingham
Mr Jim McDonald	Consultant Orthodontist, Edinburgh
Dr Moray Nairn	Programme Manager, SIGN
Dr Janet Pollock	Consultant Anaesthetist, Southern General Hospital, Glasgow
Dr Michal Scullion	General Practitioner, Alexandria
Dr Robin Smith	Consultant Respiratory Physician, Ninewells Hospital, Dundee
Professor John Stradling	Consultant Respiratory Physician, Churchill Hospital, Oxford
Mr Paul White	Consultant Otolaryngologist, Ninewells Hospital, Dundee

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. Guideline development and literature review expertise, support, and facilitation were provided by the SIGN Executive.

Professor Stradling and Dr Kinnear formally represented the British Thoracic Society in the development of this guideline and incorporated feedback from the BTS into the discussions of the group.

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 a SIGN Information Officer in collaboration with members of the guideline development group.

Internet searches were carried out on the Web sites of the Canadian Practice Guidelines Infobase, the New Zealand Guidelines Programme, the UK Health Technology Assessment Programme, the US National Guidelines Clearinghouse, and the US Agency for Healthcare Research and Quality. Searches were also carried out using Google and OMNI search engines, and all suitable links followed up.

Database searches were carried out on the Cochrane Library, Embase, Medline, and Psychological Abstracts. With the exception of the Cochrane Library, all searches were restricted to the period 1991 – 2000. The Medline version of the main search strategies is available on the SIGN Web site, in the section covering supporting material for published guidelines.

The main searches were supplemented by material identified by individual members of the development group.

8.4 Consultation and peer review

8.4.1 NATIONAL OPEN MEETING

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 3 April 2001 and was attended by 77 representatives of all the key specialties relevant to the guideline. 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.

8.4.2 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.

Mr Grant Bates	ENT Surgeon, Radcliffe Infirmary, Oxford
Dr Jim Beattie	Director of Guideline Development, RCGP
Dr Alan Begg	General Practitioner, Montrose
Professor Peter Calverley	Professor of Respiratory Medicine, University Hospital, Liverpool
Dr Jim Catterall	Consultant Respiratory Physician, Bristol Royal Infirmary
Mr Charles Croft	Consultant ENT Surgeon, Royal Ear Nose and Throat Hospital, London
Mr John Crowther	Consultant ENT Surgeon, Victoria Infirmary, Glasgow
Professor John Gibson	Consultant Respiratory Physician, Newcastle upon Tyne
Mr Frank Govan	Chairman, Sleep Apnoea Trust
Dr Geoff Hulks	Consultant Physician, Raigmore Hospital, Inverness
Dr Ama Johal	Consultant Orthodontist, Department of Oral Growth and Development, Dental School Division, London
Dr Max Kalsi	Specialist Registrar in Public Health Medicine, Chesterfield Primary Care Trust
Mr Ken MacKenzie	Consultant Head and Neck Surgeon, Glasgow Royal Infirmary
Mr William McKerrow	Consultant ENT Surgeon,Raigmore Hospital, Inverness
Dr Allan Merry	General Practitioner, Ardrossan
Ms Debby Nicoll	Specialist Nurse, Sleep Unit, Churchill Hospital, Oxford
Dr Paul Rafferty	Consultant Physician, Dumfries & Galloway Royal Infirmary
Dr John Wright	Consultant in Public Health, Bradford

8.4.3 SIGN EDITORIAL GROUP

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

Dr David Alexander	BMA Scottish General Practice Committee
Mr Douglas Harper	Royal College of Surgeons of Edinburgh
Professor Gordon Lowe	Chairman of SIGN
Dr Lesley Macdonald	Faculty of Public Health Medicine
Professor Nigel Pitts	National Dental Advisory Committee
Dr Safia Qureshi	SIGN Programme Director
Dr Sara Twaddle	Director of SIGN