232 Chapter 7 a test. In order to facilitate effective and efficient guideline development for healthcare related testing, it appeared crucial to transparently present all considerations. In addition, this thesis determined the knowledge required to adequately develop healthcare related testing guideline recommendations and provided a tool to facilitate the specification of the test-management pathway. This facilitates considering peopleimportant outcomes when formulating guideline questions on healthcare related testing. If ‘good guidelines can only make you better’ [50], ‘guidelines would be as transparent as possible in revealing dilemmas and uncertainties’ [51], and ‘the challenge of scientific research is to formulate the question’ [52], then this thesis adds evidence to the growing pile of knowledge about appropriate guideline development on healthcare related testing. It contributes to the goal of providing healthcare professionals and consumers with trustworthy guidance on testing, with the aim of reducing or preventing overtesting and undertesting, and associated overtreatment and undertreatment, and improving people-important outcomes. Recommendations for practice The aim of this thesis is to facilitate and improve guideline development concerning healthcare related testing. To achieve this, the results of the research conducted should be integrated into practice. The key message is to incorporate the testmanagement pathway concept into the development process of guidelines on healthcare related testing. This can be accomplished through two main activities: - To improve the knowledge of guideline developers regarding the importance of the test-management pathway, including related knowledge, guidance on guideline development should be updated, and this topic should be included in the training of guideline panel members and methodologists. - To facilitate the specification of a tests-management pathway during the question formulation phase by guideline panels, an online tool should be created. This tool should preferably be integrated into existing guideline development software. These recommendations for practice are discussed further in the impact chapter of this thesis. Recommendations for research Further research is necessary to continuously improve and facilitate the development of guidelines for healthcare related testing. This includes identifying the required knowledge for guideline methodologists and panel chairs to develop appropriate recommendations on testing, in addition to the knowledge components for guideline
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