194 Chapter 6 pathways for their topic of interest was drawn and their feedback was incorporated into the draft step-by-step guide. User testing workshop with experts Workshop participants were healthcare professionals and researchers with expertise and/or interest in guideline development who participated in the DECIDE Conference in Edinburgh in June 2014. We provided the participants with a 15-minute introduction on the relevance of creating a test-management pathway in developing testing recommendations and presented our proposed approach. Then, test-management pathways were drafted using the step-by-step guide for two example questions: (1) B-type Natriuretic Peptide (BNP) testing for heart failure in elderly patients, and (2) CT-scanning in children with head injury who present at the emergency department. These topics were proposed by two volunteer participants. The test-management pathways were drafted through a collaborative effort between one researcher (PMB) and these volunteers in the presence of the other participants. Another researcher (MML) documented the process on a whiteboard. Two other project team members (GG and MWL) observed the process and took minutes. Participants of the workshop gave input on these pathways, could ask questions and provided feedback. At the end of the workshop, participants completed a questionnaire about the usefulness and perceived challenges of the process used in the step-by-step guide (Appendix 1). The responses to these questionnaires were used to inform potential improvements to the step-by-step guide, including the wording of the steps. User testing with guideline panel members In this phase, conducted in 2023, we used a before-after approach, in which we asked guideline panel members to formulate a guideline question on testing without and then with the use of the step-by-step guide. We selected a purposeful sample of at least five guideline panel members from an unspecified number of guideline panels, relying on our own network in the Netherlands. To be eligible, guideline panel members had to be involved at the start or in the development process of a guideline on testing. Guideline panel members were invited to participate per email. We provided the participants with a brief description of the project and planned two interviews with each participant to collect data. The interviews were conducted by te first author of this study using the interview guides in Appendix 2. In the first interview conducted online, participants were asked to formulate a key question concerning the added value of a test for their guideline topic
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