FAQs for Users - consumers and clinicians

Recommendations are presented as indicators, which can be used in clinical practice and scored (as a list) according to whether they have been complied with (i.e. the recommended care has been provided, or not). Collectively, our clinical indicators comprise the clinical standard for the condition in question. The process (research methodology) used for their development has been termed the STANDING COLLABORATION.

What is the STANDING Collaboration?

STANDING Collaboration is part of a Program Grant (APP1054146) awarded from the National Health and Medical Research Council (NHMRC). We are a group of researchers based at the Centre for Population Health Research at the University of South Australia (UniSA), and our work centres around creating safe and effective systems of healthcare - one of the cornerstones of which is developing and disseminating up-to-date information about the type of healthcare that is recommended, and that which is not.

Using recommendations in clinical practice guidelines, we have developed indicators for care for various health conditions and procedures. We are inviting healthcare professionals and consumers to review these indicators and provide feedback.

The aim of STANDING Collaboration is to establish nationally agreed sets of clinical indicators for medical conditions, using:

  • a single open and collaborative process which allows health care professionals and consumers to comment on indicators using their experience
  • a live and online wiki-based platform to facilitate ongoing review and updating
  • by logging the source and provenance of clinical indicators for transparency

How does STANDING Collaboration work?

Using recommendations in clinical practice guidelines, the Research Group (project team) developed indicators for care for various health conditions and procedures. We are inviting healthcare professionals and consumers to review these indicators and provide feedback.

A Clinical Champion and Curator Group (expert panel) for each condition has reviewed the indicators before the site went live to the public, and will make ongoing recommendations about the feedback you provide (as a registrant). More information about the Clinical Champion and Curator Group can be found in the condition of interest (e.g. low back pain, hypertension)

You have the opportunity to provide feedback on an ongoing basis if you wish, and to see how the indicators have been changed by the Clinical Champion and Curator Group in response to your feedback.


What is a clinical standard?

A clinical standard1 is a set of agreed processes that should be undertaken or outcomes that should be achieved for a particular circumstance, symptom, sign or diagnosis. It should be evidence-based, specific, feasible to apply, easy and unambiguous to measure, and produce a clinical benefit and/or improve the safety and/or quality of healthcare at least at a population level. In STANDING Collaboration, we are initially developing ‘standards of care’ for the conditions low back pain, and hypertension. For example, a component of a low back pain clinical standard would be: “Bed rest should be avoided”.


1 Runciman WB, Coiera EW, Day RO, Hannaford NA, Hibbert PD, Hunt TD, et al. Towards the delivery of appropriate health care in Australia. Med J Aust. 2012 16.7.2012;197(2):78-81.


What is a clinical indicator?

A clinical indicator1 is a measurable component of the standard, with explicit criteria for inclusion, exclusion, time-frame and setting. For example, a low back pain clinical indicator would be: “People with low back pain are advised NOT to rest in bed”. The full set of clinical indicators for a particular condition collectively constitute the clinical standard for that condition.


1 Runciman WB, Coiera EW, Day RO, Hannaford NA, Hibbert PD, Hunt TD, et al. Towards the delivery of appropriate health care in Australia. Med J Aust. 2012 16.7.2012;197(2):78-81.


Why should I participate in STANDING Collaboration?

STANDING Collaboration presents you with the opportunity to provide feedback on our proposed indicators based on your experience and interest. Your perspectives will be used to shape the clinical standards and indicators for the basic care of these conditions and procedures. It’s a way of having your say about what healthcare should be delivered, and how.


Am I eligible to participate in STANDING Collaboration?

You are eligible to participate if you are a healthcare professional, consumer, patient, or carer with experience or an interest in low back pain or hypertension. We welcome everyone’s feedback and value it equally.


What is a Curator Group?

The Curator Group will provide expert advice during the development and updating of the clinical standards and indicators. Curator Group members are selected for their expert knowledge, and/or experience on the condition under consideration. Members include clinicians, researchers, and consumers. The Curator Group will also give giving advice on whether to update the indicators in light of new evidence and participating in condition reviews.


What is a Clinical Champion?

The Clinical Champion is a prominent leader in the condition under consideration. He/she is part of, and lead of, the Curator Group and are charged with final decision-making authority on the indicators for the standard using Curator Group members’ reviews and feedback.


What is provenance and why is it important?

The indicator’s provenance is the evidence, literature, opinions, and suggestions used to develop the indicators, and how they change over time in response to new information.

The provenance of each indicator is presented on the wiki and updated as necessary; this is important because it allows tracking of the evolution of the standards and indicators from the original recommendations on which they were based to their final iteration, as well as the nature and influence of review feedback in shaping the standard. In addition, each person commenting on the indicators has to complete a Conflict of Interest (COI) declaration, which will be taken into consideration when accepting or rejecting suggestions, and logged along with the provenance for transparency so that site users can understand how decisions have been made in updating the indicators.


What do I need to do to participate in STANDING Collaboration?

You will need to register your interest on this website by completing personal details (including any conflicts of interest, more information can be found here). Your registration will be reviewed by our project team who will send you an email explaining the next steps in the process. Once you’ve been approved to participate, you will be invited to review a set of proposed indicators for your nominated condition(s) and provide feedback. At various time-points, our Clinical Champion and Curator Group (expert panel) will review all the feedback and subsequently make changes to the indicators. You will be able to view all the feedback and how and why decisions have been made about the next version(s) of the indicators.


Why do I need to answer questions about conflict of interest when I register?

Each person commenting on the indicators has to complete a Conflict of Interest (COI) declaration, which will be taken into consideration when accepting or rejecting suggestions. This is important because we need to be able to identify a person’s interests that may conflict with the aims of this project (e.g. if someone is making comments that would benefit the interests of their company or organisation).


Can I do my STANDING Collaboration review on any computer, tablet or mobile device?

Yes – the STANDING Collaboration site is designed to respond and adapt to a range of devices (e.g. computer, tablet, smartphone). However, like any other site, it is important to note that some organisational firewalls may prevent access.


How long will it take me?

The main reason we are asking for your help is because we know the guidelines provided to clinicians now are not being used, and we believe that your comments will help us to refine the indicators so that they are easy for clinicians and consumers to understand and use. We anticipate that if you wanted to review all the indicators in one sitting, it may take up to an hour. You may prefer to participate in smaller blocks of time, whenever is most convenient to you. Simply log in each time you visit.

Also we update the indicators every three to six months, taking into account comments received to that point. You may therefore like to set yourself a reminder to check back and comment again.


What happens to the information I provide to STANDING Collaboration?

Only members of the STANDING Collaboration Research Group will have access to your personal information.

We are guided by University of South Australia ethics guidelines and will take all reasonable steps to protect all of the information we hold from misuse, interference and loss, and from unauthorised access, modification or disclosure. Your information will be stored on a password protected electronic database, which is maintained by a third party on a virtual server. We have existing arrangements which require those third parties to maintain the security of the information. We take reasonable steps to protect the privacy and security of that information, but we are not liable for any unauthorised access or use of that information. Your personal information will stay on the database indefinitely until you advise you would like it removed, unless we de-identify it or destroy it earlier in accordance with the NHMRC ethics requirements for this study. When you post feedback to the site, an arbitrary identifier is used instead of your name. This means that while other people can see the comments and feedback you have provided (and any accompanying conflicts of interest), your identity remains anonymous. Please refer to the STANDING Collaboration Terms of Reference for further information.


Any further questions?

If you have any further queries about our project or need help to navigate the site, please contact one of our project team:

Dr Louise Wiles
Project Manager
Email: Louise.Wiles@unisa.edu.au
Telephone: (08) 8302 1210

Dr Jacqueline Stephens
Research Fellow
Email: Jacqueline.Stephens@unisa.edu.au
Telephone: (08) 8302 1339