Details of the search questions and strategy (including the definition of populations, interventions and outcomes) are outlined in Appendix 2. BHIVA adult ART guidelines were last published in 2008 [4]. For the 2012 guidelines the literature search dates were 1 January 2008 to 16 September 2011 and included MEDLINE, EMBASE and the Cochrane library. Abstracts from selected conferences (see Appendix 2) were searched between 1 January 2009 and 16

September 2011. For each topic and healthcare question, evidence was identified and evaluated by Writing Group members C646 chemical structure with expertise in the field. Using the modified GRADE system (Appendix 1), panel members were responsible for assessing and grading the quality of evidence for predefined outcomes across studies and developing and grading

the strength of recommendations. An important aspect of evaluating evidence is an understanding of the design and analysis of clinical trials, including the use of surrogate marker data. Limited further searches concerning specific third agents (rilpivirine [RPV] and elvitegravir [ELV]/cobicistat [COBI]) covering the period from September 2011 were carried out in 2013. For a number of questions, GRADE evidence profile and summary of findings tables were constructed, using predefined and rated treatment outcomes (Appendix www.selleckchem.com/products/ink128.html 3), to help achieve consensus for key recommendations

and aid transparency of the process. Before final approval by the Writing Group, the guidelines were published online for public consultation and an external peer review was commissioned. BHIVA views the involvement of patient and community representatives in the guideline development process as essential. The Writing Group included two patient representatives appointed through the UK HIV Community Advisory Board (UK CAB) who were involved in all aspects of the guideline development Cell press process. In addition, two meetings with patients and community representatives were held to discuss and receive feedback and comment on the proposed guideline recommendations. The first was held before the Writing Group’s consensus meeting and the second as part of the public consultation process. The GRADE Working Group [3] has developed an approach to grading evidence that moves away from initial reliance on study design to consider the overall quality of evidence across outcomes. BHIVA has adopted the modified GRADE system for its guideline development.