Frequently Asked Questions

Q1 : How Are IMACE Clinical Practice Guidelines Developed?

Institute for Medical Advancement and Clinical Excellence (IMACE) develops clinical practice guidelines through a rigorous, transparent, and evidence-based process to help healthcare professionals make informed decisions and improve patient care in Hong Kong. The process is guided by the principles of scientific evidence, patient-centred care, transparency, collaboration, and local healthcare needs.

In simple terms, the process involves seven key phases:

Choosing the Topic – IMACE identifies and prioritises important healthcare topics where guidance may improve patient outcomes, such as disease diagnosis, treatment modalities, or the application of new healthcare technologies. The aim is not only to reduce unnecessary or ineffective medical practices, but also to eliminate significant and unwarranted variance in clinical practice.
Defining the Scope and Consulting Stakeholders – An interdisciplinary group of experts comprising Specialist Doctors, healthcare professionals and other experts determines what questions the guideline will address and what issues will be covered. Healthcare organisations, professional bodies, patient groups, and other stakeholders are invited to share their views on the identified topic, scope and review questions prior to publication. Please click here to view the list of stakeholders.
Reviewing Evidence – Once the scope and review questions are confirmed, experts conduct comprehensive reviews of the latest scientific research. External experts and health economists may also be engaged where appropriate, especially in cases where significant implications for healthcare financing and sustainability are expected.
Developing Recommendations – A dedicated Task Force carefully examines the scientific evidence, considers local healthcare needs and patient outcomes, and develops recommendations based on the best available evidence and expert consensus.
Quality Assurance and Stakeholder Consultation – Draft guidelines undergo independent quality review to ensure recommendations are clearly linked to the evidence and aligned with the guideline’s scope and methodology. Draft recommendations are then released for another round of stakeholder consultation, allowing additional feedback and necessary revisions.
Final Approval and Publication – Feedback received during consultation is reviewed, revisions are made where appropriate, and the final guideline is formally approved by IMACE’s governing bodies before publication.
Dissemination, Review and Update – Once published, guidelines are disseminated to healthcare professionals and stakeholders across Hong Kong. IMACE continuously monitors new evidence and updates its guidelines when necessary to ensure recommendations remain current and relevant.

In summary, IMACE clinical guidelines are developed by independent experts using the best available scientific evidence, informed by stakeholder input, reviewed through robust quality assurance processes, and regularly updated to reflect advances in medicine and the healthcare needs of Hong Kong.

Q2: Why is Transparency Important?

Transparency in the present context means being open about how recommendations are developed and how decisions are made. IMACE believes that people should be able to understand where our recommendations come from, what evidence is considered, and how different views are taken into account. Transparency means having a development process that is clear and open so stakeholders can understand how guidelines are formulated.

Being transparent helps build trust. Healthcare professionals, patients and the public can have greater confidence in a guideline when they know that recommendations are based on evidence, expert input and a fair process rather than the views of any single individual or organisation. Stakeholder consultation and clear documentation of decisions are recognised as important parts of ensuring transparency in guideline development.

Q3: How Does IMACE Manage Conflicts of Interest?

Managing conflicts of interest is an important part of maintaining public trust and confidence in IMACE’s guidelines and recommendations. All individuals involved in the development of clinical practice guidelines, including experts, Task Force members and advisers, are required to declare any interests or relationships that may be relevant to the subject under consideration. IMACE reviews these declarations in accordance with its established policies and implements appropriate measures where necessary to ensure that the guideline development process remains fair, objective and focused on the best interests of patients.

IMACE manages conflicts of interest through the principles of avoidance, declaration and management. Where a potential or actual conflict of interest cannot be avoided, the individual concerned is required to make a full declaration as early as possible. Depending on the nature and significance of the conflict, IMACE may take a range of management measures, which include restricting participation in discussions or decision-making, requiring withdrawal from consideration of specific issues, appointing independent experts to provide oversight or review, or reassigning responsibilities to other members. All declarations and management decisions are properly documented to ensure transparency and accountability.

In addition, IMACE adopts a two-tier declaration system. Members are required not only to declare interests when specific matters are under consideration, but also to maintain a register of declarable interests that is updated upon appointment and periodically thereafter. This helps strengthen transparency and reinforce public confidence in the integrity of IMACE’s processes.

IMACE uses interest declarations, independent oversight and appropriate conflict management measures to ensure that its clinical guidelines and recommendations are based on the best available evidence and professional judgement.