The second European evidence-based Consensus on the diagnosis and management of Crohn's disease: Definitions and diagnosis

The strategy to reach the Consensus on the guideline revisions involved six steps:1. Guideline statements of 2004 were analysed systematically by the chairs of the working parties.Guideline statements selected for change and questions unresolved by the 2004 ECCO guidelines were distributed to the working party members.Participants were asked to answer the questions based on their experience as well as evidence from the literature (Delphi procedure). 62. In parallel, the working parties performed a systematic literature search of their topic with the appropriate key words using Medline/Pubmed and the Cochrane database, as well as their own files.The evidence level (EL) was graded (Table 1.1) according to the Oxford Centre for Evidence-Based Medicine. 73. Provisional guideline statements on their topic were then written by the chairmen, posted on a weblog.Discussions and exchange of the literature evidence among the working party members was then performed on the weblog.This process was supervised by Axel Dignass and Gert Van Assche.4. On September 30 all working party chairs submitted the proposed changes to the 2004 guidelines to Gert Van Assche and Axel Dignass, who compiled them in a working document.5. The working parties then met in Vienna on the 18th October 2008 to agree on the statements.Technically this was done by projecting the statements and revising them on screen until a consensus was reached.Consensus was defined as agreement by >80% of participants, termed a Consensus Statement and numbered for convenience in the document.Each recommendation was graded (RG) according to the Oxford Centre for Evidence Based Medicine, 7 based on the level of evidence (Table 1.1).6.The final document on each topic was written by the chairmen in conjunction with their working party.