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Table 2 The processes for developing Choosing Wisely recommendations in Finland

From: Highlighting the need for de-implementation – Choosing Wisely recommendations based on clinical practice guidelines

  Process A. Based on a published guideline Process B. Integrated with guideline production or update Process C. Independent recommendation
Step 1. Topic proposal An editor reviews the guideline for possible recommendations A proposal from a guideline development group member, discussed in the group A proposal from a medical specialty society, other organization or individual
Step 2. Recommendation draft with justification The editor based on the guideline and evidence summaries Group member based on literature search and critical appraisal An editor based on literature search and critical appraisal
Step 3. Review and revision Revisions based on comments from the chair and relevant guideline development group members.
Final approval by the Editor-in-Chief (documented).
Informing the group and possible comments.
Comments from the group.
External review (of the guideline draft).
Possible revisions.
Final approval by the Editor-in-Chief (documented).
Comments from 1 to 2 topic experts, possible revisions.
External review (of the recommendation): e-questionnaire, quality criteria assessed with a Likert scale from 1 to 5.
Possible revisions.
Final approval by the Editor-in-Chief (documented).
Step 4. Publishing Incorporating the recommendations into the guideline.
Technical editing and publishing.
Incorporating the recommendations into the guideline.
Technical editing and publishing.
Technical editing and publishing.