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The review process represents the most comprehensive review of the lifeguarding literature to date. The process fosters collaboration among the multiple disciplines with expertise that supports lifeguarding and aquatic rescue. These include not-for profit professional and technical organizations, scientific researchers and government agencies.

The process includes key components and specific conflict management procedures:

Key Components:

• Evidence-based
• Thorough, detailed, collaborative and unbiased
• International in scope
• Involve individuals that implement the guidelines and those who work using the guidelines
• Include many opportunities for input throughout the process

Steps:

This effort is accomplished through a multi-step validated evidence based guidelines development process. This includes:

• Investigation of the history of safety and rescue protocols currently in existence.
• Establishing definition for key terms in this field.
• Defining the scope of the process and the questions to be addressed.
• For each area to be addressed, developing a hypothesis and/or scientific question.
• Reviewing the available evidence using a validated and standardized approach. At least two experts review each topic, rating the level and quality of evidence using a standardized evidence evaluation process to develop a "worksheet" for each topic. The evidence to be reviewed includes but not limited to:
1. Population-based studies
2. Epidemiological studies
3. Case-control studies
4. Historic research
5. Case studies
6. Large observational studies
7. Review of past research summaries, and
8. Extrapolations from existing data collected for other purposes
• Presentation and approval by coalition members of the evidence review. Each topic is presented, discussed and critiqued by the assembled experts until a consensus is reached.
• Open comment on proposed guidelines. The draft guidelines are then posted to a public web site for a comment period. In addition representatives of organizations that set regulations, standards, or practice guidelines in lifeguarding will have an opportunity to react to the science review and provide comments for consideration. Following the comment period the received feedback is reviewed by the experts to determine if an alteration of the guideline is warranted.
• Publication of guidelines with evidence review.
• Public distribution of final guidelines.

Managing Conflicts:

The United States Lifeguard Standards Coalition considers conflict of interest of the utmost importance in maintaining the integrity of the evidence evaluation process. Every effort to resolve any real or perceived conflicts of interest during the entire science review process is made. Every participant completes and updates a conflict of interest disclosure form. Each attendee of the process is given a conflict of interest (COI) booklet, which lists all COI information for every participant. In addition this COI information will be posted on the public web site.

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