Background: Together with healthcare professionals, the Dutch National Health Care Institute (NHCI) recently updated the Dutch Guide to Guidelines. In its recent version it is stressed that knowledge gaps that result from a lack of evidence should be specified in the guideline in order to stimulate research. Besides its role in guideline development, the NHCI also assesses evidence for the purpose of reimbursement decisions.
Tool: In the context of its reimbursement decisions the NHCI developed the FIT tool (Feasible Information Trajectory). This tool helps to identify evidence (knowledge) gaps and gives insights in how these gaps can be filled, if at all. FIT is a computerised tool that starts with several PICO(ts)-related questions and reveals feasible research characteristics from the answers to these questions. It then contrasts the feasible characteristics with the characteristics of the research in the available evidence and visually shows the knowledge gaps as the discrepancy between feasible and available research.
Discussion: Although developed in the context of reimbursement decisions, guideline developers may also want to apply the FIT tool for determining knowledge gaps. Through application of the FIT tool they specify their exact research needs and by doing so they may provide a major impulse to more targeted research initiatives when researchers take up the challenge of providing the necessary research to fill in existing knowledge gaps.