Advice on the production of guidelines



The Clinical Services and Standards Committee of the British Society of Gastroenterology have undertaken to work with colleagues to prepare guidelines on the management of various gastrointestinal disorders in order to improve the standard of practice of clinical gastroenterology in specified areas.  The NHS Executive requires that guidelines should be evidence based and well referenced. The following is intended as a guide to aid in the preparation of guidelines to improve the standard of practice of clinical gastroenterology in specified areas.

This template is only a framework on which guidelines should be built. The format does not have to be rigid and may be varied according to subject matter, but the principles should apply.

Update revisions of previous BSG guidelines may be published as a BSG document independent of GUT, depending on the scale of the revision.


  • Guidelines will be commissioned through the Vice-Chairman of Clinical Services and Standards Committee (CSSC) who is the Associate Editor of GUT for guidelines. The Vice-Chairman with the Editor GUT will commission the guideline at the outset. Proposals for guidelines may be directed to the Vice-Chairman through the BSG office.
  • Guidelines may be initiated or proposed by Clinical Services and Standards Committee, Council, GUT, specialist sections or external bodies. It is recommended that individuals who have a particular interest in a topic submit their proposal through the appropriate specialist section, as single or dual author guidelines are not considered for publication.
  • Guidelines need to be the product of a large group of individuals who are recognised authorities in their field. Self-elected single authors are discouraged. Guidelines will be written by a working party to include a steering committee (usually at least 4 members) and other authors representing a wide range of those with special relevant expertise as well as those whose everyday practice will be influenced by the guidelines.
  • Guidelines are produced because the group feel that there have been important recent advances in understanding and treatment which make such an enterprise worth doing. If there have been no significant changes then the exercise is unlikely to offer more than can already be gleaned from a textbook of Gastroenterology.
  • The BSG and GUT aim to choose the best proposals. The Vice-Chairman CSSC and the Editor of GUT will discuss the commissioning of the new guidelines from the start of the process. A decision will be made as to which are suitable for GUT and which are not. Those not suitable for GUT may be suitable for a sub-specialty journal (eg “endoscopy”), the BSG website or a paper document to be distributed by the Society.
  • Guidelines to be published in GUT will be up to 15,000 words in length and well referenced, ie 100-200 references (in addition to the 15,000 word limit). Tables are encouraged in addition to the 15,000 word limit. The limit excludes additional data which may be submitted as a supplementary file to be available online only.
  • Guidelines will follow the AGREE standards (attached).


Development of the guideline may follow the instrument for the appraisal of guidelines for research & evaluation (AGREE, attached). You should establish at the outset:

1. Scope & purpose.

  • Aim. Are the guidelines new or an update?
  • What questions are to be addressed.
  • What is the target population of patients?
  • What is the target audience? Generally this will be Consultant and Specialist Registrars in Gastroenterology-related specialities, purchasers, and international readers. Readership is estimated in terms of Document distribution, GUT impact factor, and internet “hits”.

2. Working party.

  • The steering committee should be recruited from relevant BSG Sections & other GI societies, such as AUGIS, ACP, BASL etc and should include patient representatives (recruited from Societies such as NACC or via RCP Patient & Carer Network).

3. Rigour of development.

  • In order to finalise the recommendations, the working party should meet and vote on the strength of recommendations, the AGREE tool (attached) may be helpful in this context.
  • Strength of recommendation is discussed below.
  • There must be editorial independence therefore commercial sponsorship is discouraged and usually not acceptable.
  • State the schedule for review, usually 5 years but may be sooner for rapidly developing topics.
  • Peer review of the guidelines will be by CSSC, Council and 2 external reviewers appointed by GUT.