32 WORLD GASTROENTEROLOGY NEWS APRIL 2015 Editorial | Expert Point of View | Gastro 2015: AGW/WGO | WDHD News | WGO & WGOF News | WGO Global Guidelines | Calendar of Events the gold standard for colorectal cancer screening is not implemented. Such a decision is based on economic and organizational reasons: by our own cascades those countries use level 6 recommendations and don’t apply the ‘gold standard’ – now this is an example of how resources or resource based decisions, i.e. no funds available and not enough endoscopists to screen a good portion of the population, make the gold standard ‘useless’. How are WGO guidelines ‘global’? We look for topics that have relevance especially outside of the Western world, i.e. where epidemiology and quality of life impact of a disease are substantial, and where resources are sub-optimal to fully implement gold standard recommendations. This is often related to disease prevalence and the costs involved because large populations are affected and need help, e.g. viral hepatitis. And there may be a huge variation in the approach because of cultural differences, for instance constipation and the use of herbal solutions or a completely different balance in the involvement of other health care providers as reflected in our Common GI Symptoms guideline with Cascade options for self-help, pharmacists, and primary care physicians. How do we maintain quality and reliability? We realize and maintain quality and reliability by having broad, expert based Review Teams. And, although the physician is always carrying the final responsibility for his/her actions taken, our guidelines are a tool to consider options and pathways that are best for groups of patients as reflected in the literature and as viewed by teams our experts. Evidence is a key element in the development of our guidelines but it must be seen in perspective, in relation to clinical practice, availability of investigations, treatments, trained professionals, access of patients, and cultural limitations. Throughout history, both ‘evidence’ and ‘expert opinion’ have been proven to be wrong sometimes, and they may have been less distinguished from each other than often presented. In our guideline development process we challenge available evidence with expert opinion and vice versa. Evidence and expert opinion are both important ingredients to make guidelines and much depends on the quality of the sources, i.e. the selection of systematic reviews and meta-analyses and the experience and knowledge of our Guideline chairs and our Review Team members. Strategy for dissemination – Our guidelines are published on our own website (www.worldgastroenterology. org) and in the JCG. A selection is published in a few other journals and also reviewed and published on NGC. Our guidelines in the JCG are indexed in bibliographic databases, such as Medline/Pubmed and EMBASE. Articles also appear in e-WGN and e-Alerts when new or updated guidelines are published. “Thank you on behalf of our global users” to all our experts. The enthusiastic participation of our Guidelines chairs, Review Team and committee members, WGO Member Societies, and partner organizations, allows us to realize our Global Guidelines. Are you interested in participating? Help us make Global Guidelines! Review Team members are volunteers, experts from the field, and it is important to have clinicians from regions with limited resources.
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