Grading quality of evidence and strength of recommendations in clinical practice guidelines Part 3 of 3. The GRADE approach to developing recommendations
Por:
Brozek, JL, Akl, EA, Compalati, E, Kreis, J, Terracciano, L, Fiocchi, A, Ueffing, E, Andrews, J, Alonso-Coello, P, Meerpohl, JJ, Lang, DM, Jaeschke, R, Williams, JW, Phillips, B, Lethaby, A, Bossuyt, P, Glasziou, P, Helfand, M, Watine, J, Afilalo, M, Welch, V, Montedori, A, Abraha, I, Horvath, AR, Bousquet, J, Guyatt, GH, Schunemann, HJ
Publicada:
1 may 2011
Resumen:
P>This is the third and last article in the series about the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to grading the quality of evidence and the strength of recommendations in clinical practice guidelines and its application in the field of allergy. We describe the factors that influence the strength of recommendations about the use of diagnostic, preventive and therapeutic interventions: the balance of desirable and undesirable consequences, the quality of a body of evidence related to a decision, patients' values and preferences, and considerations of resource use. We provide examples from two recently developed guidelines in the field of allergy that applied the GRADE approach. The main advantages of this approach are the focus on patient important outcomes, explicit consideration of patients' values and preferences, the systematic approach to collecting the evidence, the clear separation of the concepts of quality of evidence and strength of recommendations, and transparent reporting of the decision process. The focus on transparency facilitates understanding and implementation and should empower patients, clinicians and other health care professionals to make informed choices.
Filiaciones:
Brozek, JL:
McMaster Univ, Dept Med, Hamilton, ON, Canada
Akl, EA:
McMaster Univ, Dept Med, Hamilton, ON, Canada
SUNY Buffalo, Dept Med, Sch Med & Biomed Sci, Buffalo, NY 14260 USA
SUNY Buffalo, Dept Family Med, Sch Med & Biomed Sci, Buffalo, NY 14260 USA
Compalati, E:
Univ Genoa, Dept Internal Med, Allergy & Resp Dis Clin, I-16126 Genoa, Italy
Kreis, J:
Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA
Terracciano, L:
Univ Milan, Sch Med, Melloni Hosp, Pediat Div,Dept Child & Maternal Med, Milan, Italy
Fiocchi, A:
Univ Milan, Sch Med, Melloni Hosp, Pediat Div,Dept Child & Maternal Med, Milan, Italy
Ueffing, E:
Univ Ottawa, Ctr Global Hlth, Inst Populat Hlth, Ottawa, ON, Canada
Andrews, J:
Vanderbilt Univ, Dept Obstet & Gynecol, Nashville, TN USA
Vanderbilt Univ, Evidence Based Practice Ctr, Nashville, TN USA
Alonso-Coello, P:
Inst Biomed Res CIBER Epidemiol & Publ Hlth CIBER, Clin Epidemiol & Publ Hlth Dept, Iberoamer Cochrane Ctr, Barcelona, Spain
Meerpohl, JJ:
Univ Med Ctr Freiburg, Inst Med Biometry & Med Informat, German Cochrane Ctr, Freiburg, Germany
Univ Med Ctr Freiburg, Ctr Pediat & Adolescent Med, Freiburg, Germany
Lang, DM:
Cleveland Clin, Resp Inst, Allergy Immunol Sect, Cleveland, OH 44106 USA
Jaeschke, R:
McMaster Univ, Dept Med, Hamilton, ON, Canada
Williams, JW:
Duke Univ, Dept Internal Med & Psychiat, Durham, NC USA
Durham VA Med Ctr, Durham, NC USA
Phillips, B:
Univ York, Ctr Reviews & Disseminat, York YO10 5DD, N Yorkshire, England
Lethaby, A:
Univ Auckland, Fac Med & Hlth Sci, Sch Populat Hlth, Auckland 1, New Zealand
Bossuyt, P:
Univ Amsterdam, Acad Med Ctr, Dept Clin Epidemiol Biostat & Bioinformat, NL-1105 AZ Amsterdam, Netherlands
Glasziou, P:
Univ Oxford, Dept Primary Hlth Care, Ctr Evidence Based Med, Oxford, England
Helfand, M:
Oregon Hlth & Sci Univ, Portland Vet Adm Med Ctr, Portland, OR 97201 USA
Watine, J:
Hop Rodez, Lab Biol Polyvalente, Rodez, France
Afilalo, M:
McGill Univ, Jewish Gen Hosp, Montreal, PQ H3T 1E2, Canada
Welch, V:
Univ Ottawa, Ctr Global Hlth, Inst Populat Hlth, Ottawa, ON, Canada
Montedori, A:
Reg Hlth Author Umbria, Off Reg Hlth Planning, Perugia, Italy
Abraha, I:
Reg Hlth Author Umbria, Off Reg Hlth Planning, Perugia, Italy
Horvath, AR:
Univ Sydney, Sch Publ Hlth, Screening & Test Evaluat Program, Sydney, NSW 2006, Australia
Prince Wales Hosp, SEALS Dept Clin Chem, Sydney, NSW, Australia
Bousquet, J:
Hop Arnaud de Villeneuve, Serv Malad Resp, Montpellier, France
INSERM, U1018, Villejuif, France
Guyatt, GH:
McMaster Univ, Dept Med, Hamilton, ON, Canada
Schunemann, HJ:
McMaster Univ, Dept Clin Epidemiol & Biostat, Fac Hlth Sci, Hamilton, ON, Canada
McMaster Univ, Dept Med, Hamilton, ON, Canada
Bronze
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