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A Model for Developing Subspecialty Clinical...
Journal article

A Model for Developing Subspecialty Clinical Practice Guidelines: The Geriatric Emergency Department Guidelines 2.0

Abstract

The original consensus-based Geriatric Emergency Department (GED) Guidelines, published in 2014, established a framework of core principles for delivering high-quality, age-appropriate emergency care for older adults. In response to significant advances in geriatric emergency medicine research and evolving clinical priorities, we developed the GED Guidelines 2.0 to ensure continued relevance, clinical utility, and evidence-based rigor. This concept paper describes the systematic and iterative process undertaken to update the guidelines, including the formation of multidisciplinary working groups and the application of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. Unlike the original GED Guidelines, our approach prioritized methodological transparency, formalized evidence grading, and consensus building grounded in systematic reviews and meta-analyses. We describe the identification, recruitment, and collaboration of multidisciplinary clinical and academic experts working together to improve the care of older adults in the emergency department. Through this multidisciplinary effort, key geriatric domains were selected, priority topics identified, and systematic reviews and meta-analyses conducted to generate a robust evidence base for future guideline and policy development. The GED Guidelines 2.0 represents the first emergency medicine (EM) subspecialty guideline effort to fully adopt the GRADE framework, offering a novel blueprint for future EM guideline development.

Authors

Gunaga S; Carpenter CR; Kennedy M; Southerland LT; Lo AX; Lee S; Swan K; Mowbray F; Skains RM; Hogan TM

Journal

Journal of the American College of Emergency Physicians Open, Vol. 6, No. 6,

Publisher

Elsevier

Publication Date

December 1, 2025

DOI

10.1016/j.acepjo.2025.100247

ISSN

2688-1152

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