Newsletter 2025
Shaping the Future of Anaesthesiology Through Better Guidelines
Why is ESAIC changing its guideline development methods?
Since the 1970s, alongside the development of numerous new drugs and medical interventions, it became increasingly clear that clinical decision-making should be grounded in empirical evidence of effectiveness rather than opinion or personal experience. With the emergence and widespread adoption of evidence synthesis methods, particularly those developed by the Cochrane Collaboration, systematic reviews became the cornerstone of evidence-based healthcare.
Despite this progress, by the early 2010s, most clinical practice guidelines continued to rely heavily on expert consensus rather than rigorous evidence synthesis. Unfortunately, this remains true in many fields, including anaesthesiology, intensive care, perioperative medicine and pain. While improvements have been made over the years, a recent study found that the overall quality of anaesthesiology guidelines remains suboptimal—especially in areas such as methodological rigour, stakeholder involvement, and the applicability of recommendations.
As in all areas of medicine, guideline development has evolved significantly over the past 25 years. One major advancement is the development of standardised methods for identifying, summarising, and transparently using evidence to support decision-making and recommendations. ESAIC is now taking a leadership role in promoting evidence-based decision-making by adopting the highest standards in guideline methodology from 2025 onward.
What changes should you expect in ESAIC guidelines?
Implementing robust quality checks and a deeper, more systematic decision-making process comes with trade-offs. The number of recommendations that can be realistically developed in a context of finite time and resources is smaller than under more superficial approaches. Modern guidelines now focus on specific, well-defined clinical questions rather than producing broad, textbook-like documents that attempt to cover all aspects of patient management. ESAIC will prioritise quality over quantity, aiming to produce fewer but more reliable, trustworthy recommendations.
In addition, changes will be made to how guideline task forces are composed and operate. A stricter policy on conflict-of-interest management will be introduced, and a major effort will be made to foster broader participation. ESAIC aims to engage its wider community throughout the guideline development process, from selecting topics and questions to identifying relevant local evidence and reviewing draft recommendations.
Further details on these changes will be outlined in an upcoming series of articles to be published in the European Journal of Anaesthesiology. ESAIC invites all members, clinicians, researchers, and other stakeholders to actively participate in this transition toward more rigorous, transparent, and inclusive guideline development. Your input is essential to ensure that future guidelines reflect the realities of practice across Europe and beyond. Stay informed, get involved in the consultations, and help us shape the future of our speciality through better recommendations that will help patients in their journey through our hospitals and clinics.
Please give feedback on possible guideline topics to help us tailor the topics to the upcoming guidelines.
What topics would you prefer the ESAIC Guidelines Committee to prioritise for the next cycle?
Author
- Ignacio Neumann – Guidelines methologist
