The 10 selected questions were: 1. When should we introduce corticosteroids, and for how long?

After identifying the 10 questions, a specialist company was contacted to perform a literature search. Based on the literature search, a group of five bibliographic fellows from different countries, analysed the results of the search, and produced a report for each question including draft answers and supporting information with references, based on the evidence levels (Table 1) and grades of recommendation (Table 2) from the Oxford Centre for Evidence.8 The report developed signaling pathway by the bibliographic fellows was reviewed and each of the draft answers was consolidated and approved by a group of project mentors, members of the International Steering Committee. A National Steering Committee (NSC) was created including eight experts. Their main objective was to help elaborate the agenda, selleckchem identify additional delegates with good anti-TNF therapy experience, develop/approve materials, and moderate the National

Meeting with the end purpose of contributing to the development of its outputs. During the National Meeting, the 21 participants split into five small groups (Group 1 with five members and the remaining ones with four each) to review two answered questions each. The small groups were chaired by two of the members of the NSC who presented the proposed draft answers and moderated the discussion until the group had agreed on revised wording for the answers to their selected questions. All answers were classified according

to the Oxford levels of evidence (Table 1) and graded according to the Oxford grades of evidence (Table 2).8 After reaching an agreement, all participants reconvened to present their selected answers to the entire group, followed by an overall group vote to reach a consensus for each answer. If the voting did not achieve an agreement after the initial round, participants discussed the response further and proposed a new answer, one on which an agreement could be reached. If there was no consensus after two votes, there was Lepirudin no further discussion. Participants voted according to a scale from 1 (strong disagreement) to 9 (strong agreement). Consensus was defined as a score of 7–9 by ≥75% of the participants. Table 3 shows the mean scores of agreement and the percentage of participants who agreed with the answer to each question. Question 1. When should we introduce corticosteroids and for how long? Draft answer modified by National Meeting Working Group (1) When considered as a treatment option, conventional corticosteroids should be introduced in moderate to severely active Crohn’s disease of any localization (level of evidence: 1a; grade of recommendation: A). Question 2.