GRADE Guidelines: 19. Assessing the certainty of evidence in the importance of outcomes or values and preferences-Risk of bias and indirectness
Por:
Zhang, Y, Alonso-Coello, P, Guyatt, GH, Yepes-Nunez, JJ, Akl, EA, Hazlewood, G, Pardo-Hernandez, H, Etxeandia-Ikobaltzeta, I, Qaseem, A, Williams, JW, Tugwell, P, Flottorp, S, Chang, YP, Zhanag, YQ, Mustafa, RA, Rojas, MX, Schunemann, HJ
Publicada:
1 jul 2019
Resumen:
Objectives: The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) working group defines patient values and preferences as the relative importance patients place on the main health outcomes. We provide GRADE guidance for assessing the risk of bias and indirectness domains for certainty of evidence about the relative importance of outcomes.
Study Design and Setting: We applied the GRADE domains to rate the certainty of evidence in the importance of outcomes to several systematic reviews, iteratively reviewed draft guidance and consulted GRADE members and other stakeholders for feedback.
Results: This is the first of two articles. A body of evidence addressing the importance of outcomes starts at "high certainty"; concerns with risk of bias, indirectness, inconsistency, imprecision, and publication bias lead to downgrading to moderate, low, or very low certainty. We propose subdomains of risk of bias as selection of the study population, missing data, the type of measurement instrument, and confounding; we have developed items for each subdomain. The population, intervention, comparison, and outcome elements associated with the evidence determine the degree of indirectness.
Conclusion: This article provides guidance and examples for rating the risk of bias and indirectness for a body of evidence summarizing the importance of outcomes. (C) 2018 Elsevier Inc. All rights reserved.
Filiaciones:
Zhang, Y:
McMaster Univ, Dept Hlth Res Methods Evidence & Impact, 1280 Main St West, Hamilton, ON L8N 4K1, Canada
McMaster Univ, McMaster GRADE Ctr, 1280 Main St West, Hamilton, ON L8N 4K1, Canada
Alonso-Coello, P:
McMaster Univ, Dept Hlth Res Methods Evidence & Impact, 1280 Main St West, Hamilton, ON L8N 4K1, Canada
McMaster Univ, McMaster GRADE Ctr, 1280 Main St West, Hamilton, ON L8N 4K1, Canada
Inst Invest Biomed IIB St Pau CIBERESP, Ctr Cochrane Iberoamer, St Antoni Maria Claret 167, Barcelona 08025, Spain
Guyatt, GH:
McMaster Univ, Dept Hlth Res Methods Evidence & Impact, 1280 Main St West, Hamilton, ON L8N 4K1, Canada
McMaster Univ, McMaster GRADE Ctr, 1280 Main St West, Hamilton, ON L8N 4K1, Canada
Yepes-Nunez, JJ:
McMaster Univ, Dept Hlth Res Methods Evidence & Impact, 1280 Main St West, Hamilton, ON L8N 4K1, Canada
McMaster Univ, McMaster GRADE Ctr, 1280 Main St West, Hamilton, ON L8N 4K1, Canada
Akl, EA:
McMaster Univ, Dept Hlth Res Methods Evidence & Impact, 1280 Main St West, Hamilton, ON L8N 4K1, Canada
McMaster Univ, McMaster GRADE Ctr, 1280 Main St West, Hamilton, ON L8N 4K1, Canada
Amer Univ Beirut, Fac Med, Dept Internal Med, Beirut, Lebanon
Hazlewood, G:
Univ Calgary, Dept Med, Calgary, AB, Canada
Univ Calgary, Dept Community Hlth Sci, Calgary, AB, Canada
Pardo-Hernandez, H:
Inst Invest Biomed IIB St Pau CIBERESP, Ctr Cochrane Iberoamer, St Antoni Maria Claret 167, Barcelona 08025, Spain
Etxeandia-Ikobaltzeta, I:
McMaster Univ, Dept Hlth Res Methods Evidence & Impact, 1280 Main St West, Hamilton, ON L8N 4K1, Canada
McMaster Univ, McMaster GRADE Ctr, 1280 Main St West, Hamilton, ON L8N 4K1, Canada
Qaseem, A:
Amer Coll Physicians, Dept Clin Policy, 190 N Independence Mall West, Philadelphia, PA 19106 USA
Williams, JW:
Durham Vet Affairs Med Ctr, Ctr Innovat Hlth Serv Res Primary Care, Durham, NC 27701 USA
Duke Univ, Durham, NC 27701 USA
Tugwell, P:
Univ Ottawa, Dept Med, Ottawa, ON, Canada
Flottorp, S:
Norwegian Inst Publ Hlth, Div Hlth Serv, Oslo, Norway
Univ Oslo, Inst Hlth & Soc, Dept Hlth Management & Hlth Econ, Oslo, Norway
Chang, YP:
McMaster Univ, Dept Hlth Res Methods Evidence & Impact, 1280 Main St West, Hamilton, ON L8N 4K1, Canada
McMaster Univ, McMaster GRADE Ctr, 1280 Main St West, Hamilton, ON L8N 4K1, Canada
Zhanag, YQ:
McMaster Univ, Dept Hlth Res Methods Evidence & Impact, 1280 Main St West, Hamilton, ON L8N 4K1, Canada
McMaster Univ, McMaster GRADE Ctr, 1280 Main St West, Hamilton, ON L8N 4K1, Canada
Mustafa, RA:
McMaster Univ, Dept Hlth Res Methods Evidence & Impact, 1280 Main St West, Hamilton, ON L8N 4K1, Canada
McMaster Univ, McMaster GRADE Ctr, 1280 Main St West, Hamilton, ON L8N 4K1, Canada
Univ Kansas, Med Ctr, Dept Internal Med, Div Nephrol & Hypertens, Kansas City, KS 66103 USA
Rojas, MX:
Pontificia Univ Javeriana, Dept Clin Epidemiol & Biostat, Bogota, Colombia
Schunemann, HJ:
McMaster Univ, Dept Hlth Res Methods Evidence & Impact, 1280 Main St West, Hamilton, ON L8N 4K1, Canada
McMaster Univ, McMaster GRADE Ctr, 1280 Main St West, Hamilton, ON L8N 4K1, Canada
McMaster Univ, Dept Med, Hamilton, ON, Canada
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