Required knowledge 147 4 After the interviews, we changed the structure of the knowledge components. The interviewees emphasized that tests do not stand on their own but are part of a testmanagement pathway and aim to influence the health of the people tested. Since understanding the concept of the test-management pathway as the key element, we restructured the knowledge components according to the test-management pathway. Additionally, we combined knowledge components to reduce the number of items and deleted knowledge components considered less relevant. We restricted the target group of the defined knowledge components to guideline panel members (defined as healthcare professionals and consumers involved), and stated that methodologists and chairs should have more in-depth knowledge. In the final list of knowledge components, we defined ‘recall’, ‘understand’ and ‘able to apply/able to interpret’ as levels of required knowledge. The final list includes 26 knowledge components grouped into 7 domains (box 1). Discussion Main findings In this study, we defined knowledge components and the minimum level of knowledge required for the development of healthcare related testing recommendations in guidelines. Understanding the concept of the test-management pathway illustrated in figure 2, is the key component, connecting all knowledge components. Strengths and limitations This is the first study defining required knowledge for developing guideline recommendations about healthcare related testing. We believe these results fill a gap, since the development of healthcare related testing recommendations is complex and these recommendations often lack a focus on people-important outcomes [8, 10, 11]. Our study completes available frameworks for guideline developers and training programs (such as Dutch guideline courses and INGUIDE (International Guideline Training and Certification Program)) that do not yet focus on testing [13, 14]. This study has some limitations. First, the literature search was restricted to Medline and conducted in January 2022. Searching in additional databases could have resulted in more relevant articles. We tried to mitigate this by incorporating handbooks and snowballing. An update of the literature search, conducted in September 2023, revealed no new relevant publications. Inquiries with the interviewees indicated that they were not aware of any additional literature.
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