Background The German Guideline programme in Oncology (GGPO) funds and supports the development, implementation and evaluation of evidence based guidelines. An essential part of the programme is the development of quality indicators (QI) before a guideline is published. QI groups representing the multidisciplinary guideline development group including patient representatives and experts from organisations responsible for QI assessment and evaluation realise this following a standardised methodology.

Objectives To explore the effects of a standardised Quality Indicator Development Process (QIDP) on the content of guidelines and possible implications on the guideline development process.

Methods Retrospective content analysis of current guideline manuscripts. Description and categorization of changes in the guideline draft after the QIDP. Structured interview of QI groups.

Results 9 oncological guidelines including 87 QI were analysed. Changes in guideline drafts after the QIDP included: • formulation of new recommendations • specification of the wording of recommendations • specification and amendment of the predefined aims of a guideline • identification of aspects to consider for an update of the guideline. Results of the interview will be presented at the conference.

Discussion This investigation suggests a positive effect of the simultaneous QI development on guideline content concerning specificity of recommendations, clarity of aims to improve quality of care and identification of clinical questions to be addressed in future systematic reviews and/or guidelines.

Implications for Guideline Developers A simultaneous process to develop guidelines and QI is favourable not only to facilitate the assessment of guideline implementation and impact but also to improve guideline content and implementability.