GRADE Guidelines 28: Use of GRADE for the assessment of evidence about prognostic factors: rating certainty in identification of groups of patients with different absolute risks
Por:
Foroutan, F, Guyatt, G, Zuk, V, Vandvik, PO, Alba, AC, Mustafa, R, Vernooij, R, Arevalo-Rodriguez, I, Munn, Z, Roshanov, P, Riley, R, Schandelmaier, S, Kuijpers, T, Siemieniuk, R, Canelo-Aybar, C, Schunemann, H, Iorio, A
Publicada:
1 may 2020
Resumen:
Objective: The objective of this study was to provide guidance on the use of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to determine certainty in estimates of association between prognostic factors and future outcomes. Study Design and Setting: We developed our guidance through an iterative process that involved review of published systematic reviews and meta-analyses of prognostic factors, consultation with members, feedback, presentation, and discussion at the GRADE Working Group meetings. Results: For questions of prognosis, a body of observational evidence (potentially including patients enrolled in randomized controlled trials) begins as high certainty in the evidence. The five domains of GRADE for rating down certainty in the evidence, that is, risk of bias, imprecision, inconsistency, indirectness, and publication bias, as well as the domains for rating up, also apply to estimates of associations between prognostic factors and outcomes. One should determine if their ratings do not consider (noncontextualized) or consider (contextualized) the clinical context as this will may result in variable judgments on certainty of the evidence. Conclusions: The same principles GRADE proposed for bodies of evidence addressing treatment and overall prognosis work well in assessing individual prognostic factors, both in noncontextualized and contextualized settings. (C) 2020 Elsevier Inc. All rights reserved.
Filiaciones:
Foroutan, F:
McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada
Toronto Gen Hosp, Ted Rogers Ctr Heart Res, Toronto, ON, Canada
Guyatt, G:
McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada
Zuk, V:
McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada
Vandvik, PO:
Innlandet Hosp Trust, Dept Med, Div Gjovik, Gjovik, Norway
Alba, AC:
Toronto Gen Hosp, Ted Rogers Ctr Heart Res, Toronto, ON, Canada
Mustafa, R:
Univ Kansas, Dept Internal Med, Med Ctr, Kansas City, MO USA
Vernooij, R:
Biomed Res Inst St Pau IIB St Pau, Iberoamer Cochrane Ctr, Barcelona, Spain
Arevalo-Rodriguez, I:
Hosp Univ Ramon y Cajal, Clin Biostat Unit, IRYCIS, CIBER Epidemiol & Publ Hlth, Madrid, Spain
Univ UTE, Fac Ciencias Salud Eugenio Espejo, Ctr Invest Salud Publ & Epidemiol Clin, Quito, Ecuador
Munn, Z:
Univ Adelaide, Joanna Briggs Inst, Fac Hlth & Med Sci, Adelaide, SA, Australia
Roshanov, P:
McMaster Univ, Dept Med, Hamilton, ON, Canada
Riley, R:
Univ Birmingham, Sch Hlth & Populat Sci, Birmingham, W Midlands, England
Schandelmaier, S:
McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada
Kuijpers, T:
Dutch Coll Gen Practitioners, Dept Guideline Dev, Utrecth, Netherlands
Siemieniuk, R:
McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada
Canelo-Aybar, C:
Biomed Res Inst St Pau IIB St Pau, Iberoamer Cochrane Ctr, Barcelona, Spain
Schunemann, H:
McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada
Iorio, A:
McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada
Green Accepted
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