10.1 Introduction

SIGN is a collaborative network of clinicians, other healthcare professionals, and patient organisations, funded by NHS Quality Improvement Scotland. SIGN guidelines are developed by multidisciplinary groups of practising 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

10.2 The guideline development group

Dr Hamish Wallace (Chair)	Consultant Paediatric Oncologist, Royal Hospital for Sick Children, Edinburgh
Dr Chris Kelnar	(Methodologist) Reader in Child Health and Consultant Paediatric Endocrinologist, University of Edinburgh
Professor Ann Barrett	Professor of Oncology, University of East Anglia
Mrs Jane Belmore	Paediatric Macmillan Nurse, Royal Hospital for Sick Children, Glasgow
Dr Jan Clarkson	Honorary Consultant in Paediatric Dentistry and Senior Lecturer, Dundee Dental Hospital and School
Dr Alison Cozens	SIGN Fellow and Specialist Registrar in Paediatrics, Tayside University Hospitals NHS Trust, Dundee
Dr Ali El-Ghorr	Programme Manager, SIGN
Dr Brenda Gibson	Consultant Haematologist, Royal Hospital for Sick Children, Glasgow
Dr Robert Grant	Macmillan GP Facilitator, Kirkcaldy
Mr Robin Harbour	Information and Quality Director, SIGN
Dr Peter Hoare	Honorary Consultant Child and Adolescent Psychiatrist, Royal Hospital for Sick Children, Edinburgh
Dr Stewart Irvine	Consultant in Obstetrics and Gynaecology, Centre for Reproductive Biology, Edinburgh
Dr Paul Lim	General Practitioner, Falkirk
Mr Gordon MacKinlay	Consultant in Paediatric Surgery, Royal Hospital for Sick Children, Edinburgh
Mrs Ethel McNeill	Endocrine Nurse Specialist, Royal Hospital for Sick Children, Glasgow
Ms Lynn Myles	Honorary Consultant Neurosurgeon, Western General Hospital, Edinburgh
Dr Robert Simpson	Consultant Paediatrician, Dumfries and Galloway Royal Infirmary
Ms Anne Thomson	Patient Representative, Kirkcaldy
Dr Brenda Wilson	Associate Professor, Department of Epidemiology and Community Medicine, University of Ottawa, Canada
Dr John Wilson	General Practitioner, Selkirk

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.

10.3 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. The nature of the subject, the comparatively small amount of relevant literature, and the large number of questions to be addressed made this review particularly difficult. The final search strategies were developed by the SIGN Quality and Information Director together with a member of the guideline development group. These strategies are listed on the SIGN website, in the section covering supporting material for guidelines. The outputs from these searches were sifted by the guideline development group, and all potentially relevant material evaluated.

Systematic searches were carried out on the Cochrane Library, Embase, Medline, and Psychlit and covered the period from 1993 to 2000. The main searches were supplemented by material identified by individual members of the development group. This allowed the inclusion of older seminal publications and of material published during the guideline development process, although not systematically.

10.4 Consultation and peer review

10.4.1 NATIONAL OPEN MEETING

A national open meeting is the main consultative phase of SIGN guideline development, at which the guideline development group presents its draft recommendations for the first time. The national open meeting for this guideline was held on 27 March 2002 and was attended by around 80 representatives of all the key specialties relevant to the guideline. The draft guideline was also available on the SIGN website for a limited period at this stage to allow those unable to attend the meeting to contribute to the development of the guideline.

10.4.2 SPECIALIST REVIEW

The guideline was also reviewed in draft form by a panel of 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 this guideline.

Dr Alan Begg	General Practitioner, Dundee
Dr Allan Merry	General Practitioner, Ardrossan
Dr James Beattie	Director of Guidelines Development, Royal College of General Practitioners, Scottish Council
Dr Smita Bhatie	Paediatric Physician, City of Hope National Medical Centre, California, USA
Mr Robert Carachi	On behalf of the Academy of Royal Colleges and Faculties in Scotland
Professor Alan Craft	Consultant in Paediatrics, Royal Victoria Infirmary, Newcastle upon Tyne
Professor Hilary Critchley	Professor of Reproductive Medicine, New Royal Infirmary, Edinburgh
Dr Helena Davies	Consultant in Late Effects/Medical Education, The Children’s Hospital, Sheffield
Professor Tim Eden	Consultant Paediatric Haematologist / Oncologist, Royal Manchester Children’s Hospital
Professor Ian Gilmore	Registrar, Royal College of Physicians, London
Ms Wendy Hobbie	Late Effects Nurse Practitioner, Children’s Hospital of Philadelphia, USA
Dr Gill Levitt	Consultant in Oncology, Great Ormond Street Hospital for Children, London
Ms Morag McIntosh	National Organiser (Scotland), Sargent Cancer Care for Children, Glasgow
Dr Anna Meadows	Director, Survivorship Program, Division of Oncology, Children’s Hospital of Philadelphia and Professor of Paediatrics, University of Pennsylvania School of Medicine, USA
Professor Kevin Oeffinger	Professor of Family Practice and Paediatrics, University of Texas, Dallas, USA
Dr Cindy Schwartz	Associate Professor of Oncology and Paediatrics, Johns Hopkins Hospital, Baltimore, USA
Dr Rod Skinner	Consultant Paediatric Oncologist, Royal Victoria Infirmary,Newcastle upon Tyne
Dr Charles Sklar	Director, Long-Term Follow-Up Program, Memorial Sloan-Kettering Cancer Center, New York, USA
Dr Ian Sullivan	Paediatric Cardiologist, Great Ormond Street Hospital for Children, London
Dr Roger Taylor	Consultant Oncologist, Cookridge Hospital, Leeds
Professor Richard Welbury	Professor of Paediatric Dentistry, University of Glasgow Dental School
Dr Mike Wilson	General Practitioner, Dalkeith

Comments were also received from the Scottish Cancer Group.

10.4.3 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 James Beattie	Royal College of General Practitioners Scottish Council
Dr Keith Brown	Royal College of Psychiatrists
Dr Grahame Howard	Royal College of Radiologists, Faculty of Clinical Oncology
Professor Gordon Lowe	Chair of SIGN, Co-editor
Professor Nigel Pitts	Dental Health Services Research Unit, University of Dundee
Dr Safia Qureshi	SIGN Programme Director, Co-editor
Dr Sara Twaddle	Director of SIGN, Co-editor
Dr Pete Wimpenny	Centre for Nursing Practice Development, Robert Gordon University

Each member of the guideline development group then approved the final guideline for publication.

10.5 Acknowledgements

Dr Neil Wilson

Consultant Cardiologist, Royal Hospital for Sick Children, Glasgow

Scottish Intercollegiate Guidelines Network,
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Last modified 16/09/11
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