Table 1

De novo versus case 3 alternative guideline development approach

De novo approach	African Federation for Emergency Medicine alternative approach
1. Organisation, budget, planning and training.	*
2. Priority setting.	*
3. Guideline group membership.	Include advisory board (clinical and methodological).
4. Establish guideline group processes.	Include decision framework for using existing guidelines and recommendations.
5. Identify target audience and topic selection.	*
6. Consumer and stakeholder involvement.	*
7. Conflicts of interest.	*
8. Question generation.	Create broader questions that are transferable to key priority areas applicable and likely to be reported in guidelines.
9. Considering importance of outcomes and interventions, values, preferences and utilities.	*
10. Deciding what evidence to include and searching for evidence.	Clearly defining inclusion of high-quality, up-to-date guidelines and perform comprehensive searches including guideline clearinghouses, Google and traditional databases.
11. Summarising evidence and considering additional information.	Mapping evidence and/or guidelines by priority areas and/or questions.
12. Judging quality, strength or certainty of a body of evidence.	Using Appraisal of Guidelines for Research & Evaluation II appraisal for guidelines and ranking included guidelines by date, relevance and overall quality.
13. Developing recommendations and determining their strength.	Adopting, adapting or contextualising guidelines. Extract recommendations relevant to priority areas and questions. Reviewing adopted, adapted or contextualised recommendations with advisory boards.
14. Wording of recommendations and of considerations about implementation, feasibility and equity.	Reporting original working of recommendations, levels of evidence and/or strength in plain language. Considering implementation points and practice points for each recommendation that has been adopted or contextualised.
15. Reporting and peer review.	*
16. Dissemination and implementation.	*
17. Evaluation and use.	*
18. Updating.	*

*Indicates processes that are the same or implicit in both pathways.