Editorial Policy
(Last updated in 2024)
What are the criteria for guidelines to be included in Pathway’s database?
In order to be included in our database, guidelines must:
- Be available online, in the English language, and published in a peer-reviewed journal.
- Be produced by a recognized medical specialty association, a professional medical society, or a recognized group of medical experts.
- Adhere to a transparent and evidence-based search methodology that provides a verifiable systematic review of the evidence.
- Provide specific recommendations on patient care as well as an objective assessment of the supporting evidence and of the benefits and harms of the proposed tests and/or interventions.
- Provide explicit disclosure of the guideline author's conflicts of interests.
All guidelines are manually reviewed by our team for quality and relevance prior to inclusion in the database.
What other data sources are included in the database?
Pathway supplements clinical guideline recommendations with results from high quality primary sources, including meta-analyses and randomized controlled trials. For example, statistical information on the predictive value of the clinical history, physical examination, and diagnostic tests, is drawn from systematic reviews of the evidence such as those presented in the JAMA Rational Clinical Exam series. Systematic reviews of diagnostic and therapeutic interventions, such as those found in the Cochrane Library, are presented to nuance guideline recommendations. Appropriate use recommendations, such as those formulated by Choosing Wisely and the American College of Radiology, inform additional recommendations on high-value care. Landmark randomized controlled trials are drawn from an ongoing daily review of high-impact journals across all fields of medicine.
What is Pathway's peer review process?
Pathway places the utmost importance on providing high quality content. Peer review is in place at multiple steps in Pathway's editorial pipeline in order to ensure the accuracy and objectivity of our content. As new guidelines are released, recommendations as well as supporting grading of evidence are extracted and classified according to a structured schema. A first quality control step is performed by medical professionals who ensure the accuracy of the extracted recommendations. Following this, summaries of key recommendations as well as interactive algorithms are crafted by authors, and peer reviewed by specialty chief editors as well as the editor-in-chief.
How frequently is Pathway updated?
Pathway is updated regularly following a comprehensive electronic search of peer-reviewed journals, clinical databases and other resources. All efforts are made to include new guidelines in our database within 1 month of their publication.
How does Pathway assign evidence grades?
The recommendation strengths and levels of evidence are drawn from the original guideline publication. Pathway does not re-assign evidence grades.
In order to maintain consistency in the formulation of summarized recommendations, a distinction is established between “strong” and “conditional” recommendations. Strong recommendations are indicated by the use of the imperative tense, such as ‘Treat’ or ‘Offer,’ while conditional recommendations are indicated by the use of the verb ‘Consider’ or ‘Avoid.’
The strength of a recommendation is interpreted to reflect the risk/benefit balance of a specific test or intervention, rather than being mechanically derived from evidence quality. In cases where recommendation strength is not formally given, or does not incorporate a risk/benefit assessment, the strength of the wording used in summarized recommendations aligns as closely as possible with the strength of wording found in the original recommendation.
Color-coded indicators are provided as visual indicators of the level of evidence supporting a recommendation.
Pathway’s universal evidence assessment scheme is used as a heuristic to simplify rapid evidence assessment at the point of care, and to compare and contrast guidelines. It is not intended as a replacement for the original publisher’s evidence grading. The original grading of every recommendation can be assessed by tapping the evidence assessment badge.