The scale of the review process within guideline development is related to the scope of the guideline. Where the focus of the guideline is a relatively narrow clinical area, such as the use of analgesics or NSAIDs in osteoarthritis,19 the review is focused and generates relatively small numbers of papers. However, this is not always so. If the subject of the guideline is a broad clinical area, such as the primary care management of asthma in adults, the scale of the review is much larger. Within the North of England Asthma Guideline development process,21 over 9000 papers were identified as potentially relevant and over 600 had to be retrieved for reading to assess their clinical relevance. Given the scale of this task, if it is possible to use existing systematic reviews to provide off-the-shelf summaries in some of the clinical areas then this may make the task more manageable. However, it is essential to ascertain the quality of methods used in "imported" reviews and confirm the veracity of findings.
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