ESAIC Guidelines
Dear ESAIC member, please fill the form below which will help the ESAIC Guideline Committee to decide upon eligibility of your proposal. Max/6Pages(excluding tables)
Principal Applicant Details
Title
First Name
Last Name
City/Country
Email
ESAIC Membership Number
Phone
Job
Position of the principle applicant
Name of institution
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Proposal details / Scope and Objectives
1.1 What is the topic of the Guidelines Proposal?
1.2 What is the objective / rationale of the guideline?
1.3 What are the clinical questions (eventually PICO’s) covered by the guideline?
1.4 Are there already existing national / international guidelines that cover the proposed topic or have an overlap with the proposed topic? If so, please name the reference of these guidelines.
1.5 In case of an overlap with existing guidelines: what is the added value of this new guideline or update?
Stakeholder Involvement / Guideline Development group
2.1 Does the guideline development group include experts related to the topic?
2.2 Proposed members:
Member last name
Members first name
Country
Previous guideline activity (references)
Content expertise (explanation, references)
Methodology expertise (explanation, references)
Links with national/European anaesthetic societies
1
2
3
4
5
2.3 Are there methodologists involved?
Member last name
Members first name
Country
Previous guideline activity (references)
Methodology expertise (explanation, references)
Links with national/European anaesthetic societies
1
2
3
4
5
2.4 Do you already have a Guideline Task Force chairperson in mind? If so, name:
Title, First, Last name
2.5 How is international collaboration guaranteed?
6 Are there national/international societies that can be cooperated with? Are there possibilities of collaboration between ESAIC GC and National Societies?
2.7 Is there patient involvement in this guideline project?
2.8 Are there other stakeholders that need to be involved (surgical partners,etc.)?
3. Rigor of Development
3.1 What methodology will be used? (Please refer to ESAIC guidelines production SOP-guidelines@esaic.org)
3.2 Do all members have prior methodological knowledge? If not, how do you envision to provide relevant methodology training for participants?
3.3 What is the proposed timeline for this guideline project?
3.4 Regarding budget: Will ESAIC funding be required?
Yes
No
3.4 Regarding budget: Could National Societies contribute to financing?
Yes
No
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4. Presentation
4.1 Besides EJA, is the intend to publish the guideline in additional journal(s)?
5. Implementation
5.1 Is there a plan for implementation?
6. COI
6.1 Do members of the guideline have COI (see also ESAIC guideline on COI)?
I understand that to comply with ESAIC Guidelines requirements, task force for this proposal will include a methodologist to oversee the guideline development process
I understand that all task force members including the task force chair will have to complete annually the ESAIC Conflict Interest Form
I understand that the Task Force Chair can not have substantial conflict of interest regarding this guideline proposal topic.
Date and Signature (your name)
Submit
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