Developing European Hernia Society (EHS) Guideline on Incisional Hernia: methodological aspects of de-novo semi adolopment apporach
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|Background There are no guidelines on the management of incisional hernias produced with a robust methodology, which was confirmed by a systematic search and AGREE II assessment of existing guidelines. Thus, a de-novo guideline with semi adolopment approach was developed. Objective This project aims to develop a trustworthy and robust clinical practice guideline describing the best management of incisional hernia, building on evidence retrieved mostly from systematic reviews and updated for the newest scientific evidence. Methods and future prospects Hernia surgeons from universities, public and private facilities from European countries were invited to be part of the project. Fifteen working groups were established for each clinical question. Patients representatives were included to help with scoring the importance of outcomes. We organized online teaching sessions to educate the guideline team on the methodology. A skilled information specialist carried out a systematic search on three levels; 1. search for guidelines and systematic reviews (SRs); 2. search for primary studies informed by gaps in the retrieved SRs; 3. hand search. Retrieved SRs informed the search strategy for primary studies. Newly identified primary studies were pooled together with studies from SRs, if available. Risk of Bias assessment and data extraction was done de-novo for all included studies by two independent methodologists. The certainty of evidence and recommendations were developed using GRADE methodology.