SIGN 50: a guideline developer's handbook

Current status 

This handbook was issued in 2025. SIGN 50 is a ‘living’ publication, continually revised to reflect developments in SIGN methodology. For this reason, the definitive version of this handbook is published on the SIGN website. Comments on either the content or presentation of this document are welcome and should be sent to SIGN, email: sign@sign.ac.uk.

Aim of this handbook

This handbook outlines the key elements of the development process common to all SIGN guidelines. It shows our commitment to transparency about the methods and processes used to develop SIGN guidelines. With this transparency we aim to promote trust in our guidelines and instill confidence that the potential biases of guideline development have been addressed adequately and that the recommendations are both valid and feasible for practice. 

Who it's for

SIGN 50 provides a reference tool for members of SIGN guideline development groups as they work through the development process.

The handbook also aims to support others involved in guideline development to use processes that comply with best practices and meet quality standards and SIGN 50 could be used by practitioners as a starting point for their own guideline development.

How this handbook was developed

Development of this handbook was supported by the SIGN team and Healthcare Improvement Scotland staff members. The handbook was reviewed in draft form by members of SIGN Council. As a final quality control check, the handbook was reviewed by SIGN Senior Management Team. All people involved in the production of this handbook have declared all relevant interests.

More information can be found in section 14 of SIGN 50 ‘Development of the handbook’.