Background Since 1995, the Association of the Scientific Medical Societies in Germany (AWMF) maintains an open access, quality assured guideline register (www.awmf.org), currently containing 676 guidelines developed by 168 societies. While the societies are responsible for topic selection, development and content, the mission of AWMF is to promote, support and coordinate guideline development and to ensure the overall quality of the guideline register. To achieve this goal, AWMF established a new set of recommendations and rules.

Context Published manuals for guideline developers do not fully meet the requirements of our national guideline system. Our manual takes into account the - development of methodological strategies - international consensus on key criteria for “good guidelines” - target group including guideline novices and clinical experts wishing to be informed about methodological developments but to delegate project management and basic methodological work - informational need to include guidelines into the AWMF register - specific requirements of the German health care system (e.g. the patients’ rights act)

Description of Best Practice Our manual consists of two parts. The first part includes recommendations and practical advice for guideline developers. The second part includes rules AWMF applies to judge inclusion into the register (e.g. addressing the management of conflict of interests).

Lessons for Guideline Developers, Adaptors, Implementers, and/or Users Our guideline development handbook which will be updated continuously may serve as an example for methodological guidance that is based on a systematic review of the international literature as well as the identification of national requirements and experience.