TRUST-MF
FR
TRUST or BUST

Guideline comparison

Below, we have applied the simplified G-TRUST to Canadian preventive care guidelines. Domains assessed are confidence, interpretation and relevance. A quality/trustworthy score of green checkmarks suggests a quality guideline that should be considered for eligible patients. Otherwise, a more detailed appraisal is warranted.

Simplified G-TRUST: cfp.ca/content/cfp/70/6/372.full.pdf

DomainKey QuestionPrompts
ConfidenceWhat is the factual basis of the recommendations, and is this transparent in the guideline?
  • Is a systematic review available?
  • Were GRADE or another rigorous method used?
InterpretationDo I trust the people who interpreted the evidence and made the recommendations?
  • Are the guidelines free of competing interests (financial, intellectual)?
  • Have conflicts of interest been managed?
  • Are the panel members diverse?
RelevanceIs this guideline useful and applicable in my practice?
  • Are the patients, population, and context similar to mine?
  • Do the guidelines address patient-oriented outcomes? (e.g., benefits, harms in absolute numbers, considered patient values and preferences)
  • Are the recommendations clear and actionable? (e.g., decision aid, clinician FAQ)
  • Has time needed to treat/feasibility been considered?

24 topics shown

Chronic disease screening

Screening for inappropriate prescribing in older persons

Confidence
Interpretation
Relevance

A note on methods

This information is for educational purposes and based on the review of contributors to TRUST MF/FM. Two clinicians reviewed each guideline using the simplified G-TRUST to inform this table. We encourage users to review each guideline and associated documents and confirm details as needed. If there is a concern or if an error is identified, please let us know.

Many guidelines are from the Canadian Task Force on Preventive Health Care (CTFPHC), given the breadth of topics this group covers. Everyone is welcome to submit additional guidelines for inclusion in this table. Please provide an assessment based on the simplified G-TRUST when you submit a guideline.

Links to guidelines are provided. To ensure transparency, we also provide links to COI, systematic reviews, and other supporting documents when they are not readily available in the guideline. This allows users to make their own judgment as needed. For the relevance section, we relied on the availability of absolute numbers on benefits and harms either reported in the guideline, the systematic review or a decision aid. We also searched to identify how patients’ values and preferences were incorporated in the recommendations. We sometimes relied on our clinical knowledge when reporting that a decision aid may not be helpful (e.g., cervical cancer screening), and in those instances we looked for patient FAQ and, if not available, a clinician FAQ.

When a guideline was dated, we noted it. We did not use a specific timeframe to make this judgment. Reviewers did not conduct a thorough literature search to identify new studies on the subject; instead, they relied on their knowledge of the literature and used terms such as “evidence has changed” or “evidence may have changed” to reflect uncertainties. When a guideline was considered dated, even if there was a high-quality systematic review, it could not receive a global “yes” in the confidence and relevance domain. The judgment was downgraded to “Maybe.”

Since “time needed to screen” is a newer concept, we did not include this criterion in the table at this time, as many guidelines were published before this concept arose.

Some members of the TRUST group (Guylène Thériault, Donna Reynolds) are former members and authors of guidelines of the Canadian Task Force on Preventive Health Care (CTFPHC).

COI = Conflicts of Interest.