Step-by-step guide 195 6 of interest. Then we sent our step-by-step guide, asked the participant to read this guide carefully and to note any questions, if the guide was not sufficiently clear. For this part of the study, we updated the step-by-step guide using inclusive terminology and translated it into Dutch (see Appendix 3). In the second interview, conducted face-to-face, participants were asked to draw the test-management pathway for their test of interest using the step-by-step guide and answered any questions they had in the process. Then, participants were asked to adjust the originally formulated key question, if needed, and to provide feedback on the step-by-step guide and its use for this purpose. All interviews were video recorded for note-taking and for incorporating feedback in the final version of the step-by-step guide. Results Development of the step-by-step guide for creating a test-management pathway We created a guide consisting of five blocks of signalling questions concerning: (1) (P) patients/population, (2) (I) index test(s), (3) (C) current practice/comparison/control, (4) (O) people-important outcomes, and (5) link between testing and outcome(s). Pilottesting of the draft step-by-step guide on diagnosis of eosinophilia in asthma and breast cancer screening resulted in refinement of the guide and the conclusion that the order in which the questions are addressed could vary, depending on the clinical question or topic. As an illustrative case, the pilot on breast cancer screening is reported in Appendix 4. The draft step-by-step guide is shown in Appendix 5. User testing with experts Nineteen participants provided feedback on the step-by-step guide by completing the questionnaire (see Appendix 6 for detailed results). All agreed that drafting a testmanagement pathway is useful or even essential. Key issues raised were that more than one test-management pathway is likely for each guideline or key question and that all relevant stakeholders, such as healthcare professionals and consumers, should be involved in drafting the test-management pathway. About half of the participants did not immediately see a direct link between the testmanagement pathway and derivation of relevant key questions. The participants who saw a link, valued the inclusion of people-important outcomes in the pathway and mentioned that making these outcomes explicit facilitates inferring changes in people-
RkJQdWJsaXNoZXIy MTk4NDMw