Up-to-dateness of patient versions of clinical practice guidelines and potential influencing factors: a mixed-methods analysis

Background: Clinical practice guidelines (CPGs) provide recommendations and are a fundamental part of clinical practice. Following and based on CPGs, many guideline organisations also produce patient versions of CPGs (PVGs). The main objective of this study was to perform a mixed-methods analysis on the up-to-dateness of German PVGs and potential methodological influence factors. Methods: A mixed-methods analysis was conducted. First, a literature search to identify PVGs was performed between October 2022 and January 2023. PVGs fulfilling the following criteria were included: published in German, free accessible, explicit link to corresponding CPG, final version, date of literature search of CPG and publication date of PVG available (no publication date restriction). Second, interviews with experts in the PVG development were conducted and analysed using qualitative content analysis (following Mayring) with MAXQDA software. Results: 49 PVGs were included and analysed. A median of 36 months elapsed between the literature search of CPGs and the publication of PVGs. Six interviews were conducted and interviewees mostly perceived PVGs as up-to-date. However, they identified exceptions in the up-to-dateness depending on the topic or thematic chapters of PVGs. Interviewees mentioned different influencing factors such as the scientific progress and the editorial process of PVGs. Conclusion: Our findings shed light on potential issues with regard to the up-to-dateness of PVGs. In the context of a fast-moving evidence basis, it seems doubtful whether PVGs actually reflect the current state of knowledge, especially in fields with high research activity. However, some factors may not be modifiable because they essentially contribute to the quality assurance of PVGs. Further research is desirable to investigate which measures may be feasible to improve the up-to-dateness of PVGs.