Prodigy Clinical Guidance

Prodigy is designed to be a practical resource to aid healthcare professionals at the point of care, which is devised from rigorously reviewed and researched evidence, as well as providing a useful educational resource. Prodigy includes the following areas:

• Topic Summary providing a brief overview of the clinical topic, highlighting key clinical areas.
• Recommendations and guidance over key clinical areas.
• Goals and outcome measures including important treatment goals and quality indicators.
• Diagnosing information providing how best to diagnose or assess the patient.
• Prescribing information and drug recommendations to generate a prescription.
• Management – clinical scenarios containing specific detail as to how to treat particular patients.
• Evidence underpinning the recommendations in detail.

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Evidence based clinical information:

• For clinicians working in primary and first contact care.
• A comprehensive source of up-to-date clinical and prescribing information.
• Includes extensive topic coverage of over 350 topics consisting of over 1000 clinical presentations.

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Designed for healthcare professionals to:

• Reach a diagnosis.
• Prescribe rationally.
• Offer effective and safe treatment options.
• Appropriately refer for specialist assessment or management.
• Create local protocols and guidance.

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Provides clear & concise recommendations that:

• Address real-life clinical questions.
• Link to a summary of the reasoning behind the recommendation.
• Are supported by a fully referenced and detailed discussion of the evidence.

NICE has accredited the process used by Clarity Informatics to produce guidelines. Accreditation is valid for 5 years from May 2015 and is applicable to guidance produced using the processes described in the CKS Process Manual.

For full details on our accreditation visit: nice.org.uk/accreditation.

Clarity Informatics develops the clinical content for the Clinical Knowledge Summaries (CKS) for the National Institute for Health and Care Excellence for users in the UK, and publishes the clinical content on our Prodigy website for international users.

Topics are developed and reviewed by a multidisciplinary team consisting of clinicians, pharmacists, pharmacologists, information specialists, informatics analysts and technical authors. The processes used to develop and update the topics is overseen by the team leader and Clinical Editor (Dr Gerry Morrow).

A work programme is maintained to plan the specific activities of authoring team members and to inform external reviewers and stakeholders.

The topic development team is supported by the wider Clarity team which include customer support, administrators, project coordinators, software developers, database administrators and network support.

Prodigy topics are fully reviewed and updated at least every 5 years. The updated topic is quality assured by an internal and external review process before being released. We have a continuous Horizon scanning process to monitor current evidence, which may trigger a minor update of the topic. This ensures the topics are up to date and evidence published since the last review is available.

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The following principles are core to our topic development:

• Using evidence-based clinical information,
• Linking the recommendations to the evidence
• Supporting best practice
• Creating clear, concise, practical recommendations
• Guaranteeing independent review

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The process used to develop and review topics is detailed in the Quality Manual and includes the following high-level processes:

• Topic development and selection
• Scoping
• Developing clinical questions and scenarios
• Literature searching
• Evaluating and summarising the evidence
• Developing clinical recommendations
• External consultation
• Release

The best available evidence is selected to formulate recommendations and provide accurate background information (for example, on incidence and prevalence). The team are appropriately skilled to reliably assess the evidence identified by the structured literature review so that the recommendations can be formulated from the best available evidence and the limitations of the evidence base are appreciated.

• Guidelines are assessed for quality by the clinical authors using the principles outlined by the AGREE II.
• Where high quality guidance is not available, we use the best available evidence which:
  • Is dependent upon the type of clinical question being answered.
  • Have outcomes that are clinically relevant and patient-centred rather than disease-centred.
  • Has the lowest risk of bias.
  • Is generalizable to the scenario/clinical question being answered.

Prodigy has an Editorial Steering group in place to ensure that the clinical topics are safe, accurate, and responsive to the needs of users. The group consists of a mix of clinical professionals and stakeholders who will approve the processes by which:

• • New topics are identified and prioritized.
  • Topics are developed including:
  • • Identifying and gathering the evidence
    • Selecting the evidence
    • Appraising the evidence
    • Summarizing the evidence and developing recommendations
    • External review
    • Content is kept up-to-date

In addition, the Editorial Steering Group will advise:

• • • On a course of action when specific clinical content or recommendations are contentious (for example when the views of experts are strong and polarized, or when service availability is an issue)
    • On implementation and adoption of clinical topics

The external review process is an essential part of topic development. Consultation with a wide range of stakeholders provides quality assurance of topics in terms of:

• Clinical accuracy.
• Consistency with other providers of clinical knowledge for primary care.
• Accuracy of implementation of national guidance (in particular NICE guidelines).
• Usability.

International Distributors for Prodigy Clarity seeks international distributors for our Prodigy clinical decision support tool. The clinical content in this site provides recommendations for first contact diagnosis and treatment of over 350 clinical areas. The sale of this information has potential benefit for individual clinicians, professional organisation (such as universities or professional bodies) or even to nation states. We hope to attract enthusiastic sales people who are interested in an attractive rate of revenue sharing the income from international sales of access to this knowledge. If you would like to hear more about this opportunity please contact Dr Gerry Morrow, Medical Director gerry.morrow@clarity.co.uk

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Freelance Clinical Authors Clarity is keen to engage authors to create clinical content for our Clinical Knowledge Summaries and Prodigy sites. The clinical content in these sites is taken from national guidance and high quality evidence in order to provide recommendations for first contact diagnosis and treatment of over 350 clinical areas. We seek generalist clinicians, pharmacists and other biomedical graduates who have an interest and ability to create high quality written content using our accredited processes and Clarity house style. If you are interested in an attractive remuneration package and working with our team in a freelance capacity please contact Dr Gerry Morrow, Medical Director gerry.morrow@clarity.co.uk