Mariska Tuut

242 among healthcare professionals and consumers, the end-users of the guidelines. This in turn would have an impact on the quality of healthcare. For example through ultimately supporting informed and shared decision-making about testing in healthcare practice, and possibly reducing overdiagnosis and subsequent overtreatment. Guideline methodologists and chairs The results of this thesis could increase awareness among guideline methodologists and guideline panel chairs of the additional challenges involved in developing guidelines on healthcare-related testing beyond developing guidelines in general. Furthermore, it is important for them to recognise that guideline recommendations on healthcare related testing often fail to consider important factors necessary for adequate development, such as consequences of testing. Methodologists and chairs could use the defined knowledge components in their instructions to guide panel members in developing proper guidelines on healthcare related testing. The examples provided in this thesis can facilitate the uptake of the test-management pathway concept in this educational process. Furthermore, guideline methodologists and guideline panel chairs can use the step-by-step guide for specifying a test-management pathway. This will help identifying focused questions about healthcare related testing, in collaboration with guideline panel members. As previously mentioned, an online tool could aid in this process and could be integrated into guideline development software that is available on international level, such as the guideline development tool (GRADEpro). On a national level, initiatives are being taken to implement the required knowledge components for guideline panel members to adequately develop guideline recommendations about healthcare related testing and the step-by-step guide to specify the test-management pathway. Both topics are on the agenda for a Dutch Guideline Network thematic meeting (GENEVER). GENEVER is a networking community, within ‘Richtlijnen Netwerk Nederland’ (Dutch Guideline Network) that is easily accessible to professionals interested and/or experienced in guideline development and/or implementation. The bi-annual GENEVER meetings are well-attended by guideline methodologists and other professionals working in guideline development from various Dutch guideline organisations. Additionally, this thesis provides new knowledge that could be incorporated into the Dutch GRADE manuals and tools for developing guidelines on healthcare related testing [1, 2]. These reports have been developed by the Dutch GRADE Network, a formal entity of the international GRADE working group. Moreover, the new insights from this thesis could be embedded in the update of the ‘AQUA-

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