Table 1 An overview of test-treatment pathway components compared to an SR or CPG portfolio maintenance strategy

Diagnosis

(see “Diagnosis” section)

A “prevalent disease or condition” is diagnosed. Diagnosis requires a clear definition of the target condition (i.e. the disease or condition) and the use of tests to assess the likelihood of its presence or absence. In a clinical scenario, diagnostic tests include anamnesis (medical history) along with other clinical tests, such as physical examination or imaging. By setting a threshold within the test, healthcare professionals can determine the likelihood of the disease being present

The diagnosis of “prevalent outdatedness” involves the use of tests to determine the target condition’s likelihood of presence or absence. Similar to a clinical test-treatment pathway, these tests help to determine whether the target condition is likely to be present or absent. It is important to define outdatedness in advance. A threshold within a test can then be established to assess whether outdatedness is likely to be present or absent

Staging

(see “Staging” section)

Staging of a disease or condition is conducted to evaluate its stage or degree of severity. Information necessary for staging is gained with tests. Within these tests, thresholds are used to indicate the severity of the disease or condition

When “prevalent outdatedness” is diagnosed, its severity is assessed using tests. Several stages or degrees of outdatedness might result in different decisions regarding appropriate management options. Thresholds within the tests serve as criteria for categorizing stages or severity of outdatedness. Staging can also be performed when the systematic review (conclusion) or clinical practice guideline (recommendation) is still op to date

Management

(see “Management” section)

There are specific indications to select management options. Staging provides valuable information to determine which management option is most appropriate. Once a management option is chosen, actions are performed to initiate and carry out the appropriate care

Management options, such as updating, not updating, or withdrawing the SR or CPG have specific indications. Staging provided information to decide which management option is appropriate. Additionally, organizations may have several other management options (e.g. archive, re-endorse). Once the management option is selected, actions are performed specific for that option. For example, an update of the SR or CPG is initiated and carried out

Monitoring

(see “Monitoring” section)

Patients are periodically seen during follow-up visits as part of their ongoing care. The purpose of these visits is to monitor the disease or condition over time and evaluate the success of the chosen management option, detect signs of disease recurrence, or identify any disease progression

Periodic evaluation of SRs or CPGs can be performed to assess whether there is an occurrence, recurrence, or progression of outdatedness. This periodic evaluation is especially relevant when the initial staging of the target condition did not meet the threshold for selecting a specific management option (e.g. updating)