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SIGN 50: a guideline developer's handbook

Aim and structure of this manual

The principal aim of this manual is to provide a reference tool that may be used by individual members of guideline development groups as they work through the development process. SIGN 50 outlines the key elements of the development process common to all SIGN guidelines.

Only where aspects of the topic under consideration require a variation from the standard process will these be reported in the guidelines themselves.

A secondary aim of this manual is to be transparent about the methods used to develop SIGN guidelines, and to instil confidence that the potential biases of guideline development have been addressed adequately, and that the recommendations are both internally and externally valid, and feasible for practice.

Reveiw and updating of this manual

It is intended that SIGN 50 should be a ‘living’ publication,  continually revised to reflect future developments in SIGN methodology. For this reason the definitive version of this handbook is that published on the SIGN website.

Comments on either content or presentation of this document are welcome and should be sent to the SIGN Executive, Gyle Square, 1 South Gyle Crescent, Edinburgh, EH12 9EB, email:

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