Development and application of health outcome descriptors facilitated decision-making in the production of practice guidelines
Por:
Wiercioch, W, Nieuwlaat, R, Dahm, P, Iorio, A, Mustafa, RA, Neumann, I, Rochwerg, B, Manja, V, Alonso-Coello, P, Ortel, TL, Santesso, N, Vesely, SK, Akl, EA, Schunemann, HJ, Zakai, N, Cuker, A, Lim, W, Monagle, P, Kunkle, R, Witt, DM, Kahn, SR, McLintock, C, Rezende, SM, Zakai, NA
Publicada:
1 oct 2021
Ahead of Print:
1 jul 2021
Resumen:
Objective: Stakeholders involved in developing recommendations need to have a common understanding of health outcomes and the perspective of affected individuals. In this paper we report on the development and application of health outcome descriptors (HODs) to inform decision-making by panels developing guideline recommendations.
Study Design and Setting: Ten American Society of Hematology guideline panels addressing the management of venous thromboembolism developed HODs, rated their importance and health utility, applied them to prioritize outcomes, and to balance potential benefits and harms to formulate recommendations.
Results: It was feasible to involve 18 panelists in developing 127 HODs. There was high agreement (82%) across the ten panels about outcomes perceived as critical or important for decision-making. Panelists' utility ratings of the outcomes were strongly correlated with panelists' outcome importance ratings (Pearson's r =-0.88). HODs were incorporated into Grading of Recommendations Assessment, Development and Evaluation (GRADE) evidence-to-decision (EtD) frameworks to support a shared understanding of health outcomes in panel deliberations.
Conclusion: HODs serve as a valuable tool to promote an explicit, common understanding of health outcomes during clinical guideline development and across different stakeholders. They are helpful across multiple steps of guideline development to facilitate panels' judgements, aiming to avoid variable implicit interpretations of health outcomes. (C) 2021 Elsevier Inc. All rights reserved.
Filiaciones:
Wiercioch, W:
McMaster Univ, Michael G DeGroote Cochrane Canada, Hamilton, ON, Canada
McMaster Univ, McMaster GRADE Ctr, Hamilton, ON, Canada
McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada
Nieuwlaat, R:
McMaster Univ, Michael G DeGroote Cochrane Canada, Hamilton, ON, Canada
McMaster Univ, McMaster GRADE Ctr, Hamilton, ON, Canada
McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada
Dahm, P:
Minneapolis VA Hlth Care Syst, Urol Sect, Minneapolis, MN USA
Univ Minnesota, Dept Urol, Minneapolis, MN USA
Iorio, A:
McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada
McMaster Univ, Dept Med, Hamilton, ON, Canada
Mustafa, RA:
McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada
Univ Kansas, Med Ctr, Dept Med, Div Nephrol & Hypertens, Kansas City, KS 66103 USA
Neumann, I:
Pontificia Univ Catolica Chile, Dept Internal Med, Santiago, Chile
Rochwerg, B:
McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada
McMaster Univ, Dept Med, Hamilton, ON, Canada
Manja, V:
Univ Calif Davis, Dept Surg, Davis, CA 95616 USA
Vet Affairs Northern Calif Hlth Care Syst, Dept Med, Mather, CA USA
Alonso-Coello, P:
Biomed Res Inst St Pau IIB St Pau CIBERESP, Iberoamer Cochrane Ctr, Barcelona, Spain
Ortel, TL:
Duke Univ, Med Ctr, Dept Med, Durham, NC 27710 USA
Duke Univ, Med Ctr, Dept Pathol, Durham, NC 27710 USA
Santesso, N:
McMaster Univ, Michael G DeGroote Cochrane Canada, Hamilton, ON, Canada
McMaster Univ, McMaster GRADE Ctr, Hamilton, ON, Canada
McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada
Vesely, SK:
Univ Oklahoma, Hlth Sci Ctr, Hudson Coll Publ Hlth, Dept Biostat & Epidemiol, Oklahoma City, OK USA
Akl, EA:
McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada
Amer Univ Beirut, Dept Internal Med, Beirut, Lebanon
Schunemann, HJ:
McMaster Univ, Michael G DeGroote Cochrane Canada, Hamilton, ON, Canada
McMaster Univ, McMaster GRADE Ctr, Hamilton, ON, Canada
McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada
McMaster Univ, Dept Med, Hamilton, ON, Canada
Univ Freiburg, Inst Evidence Med, Med Ctr, Freiburg, Germany
Univ Freiburg, Fac Med, Freiburg, Germany
Zakai, N:
McMaster Univ, Dept Med, Hamilton, ON, Canada
Univ Vermont, Dept Med, Larner Coll Med, Burlington, VT USA
Univ Vermont, Dept Pathol & Lab Med, Larner Coll Med, Burlington, VT USA
Univ Vermont, Med Ctr, Burlington, VT USA
Cuker, A:
Univ Penn, Dept Med, Perelman Sch Med, Philadelphia, PA 19104 USA
Univ Penn, Dept Pathol & Lab Med, Perelman Sch Med, Philadelphia, PA USA
Lim, W:
McMaster Univ, Dept Med, Hamilton, ON, Canada
Monagle, P:
Univ Melbourne, Dept Paediat, Dept Haematol, Royal Childrens Hosp,Haematol Res,Murdoch Childre, Melbourne, Vic, Australia
Kunkle, R:
Amer Soc Hematol, Washington, DC USA
Witt, DM:
Univ Utah, Coll Pharm, Dept Pharmacotherapy, Salt Lake City, UT 84112 USA
Kahn, SR:
McGill Univ, Dept Med, Montreal, PQ, Canada
Lady Davis Inst, Montreal, PQ, Canada
McLintock, C:
Auckland City Hosp, Natl Womens Hlth, Auckland, New Zealand
Rezende, SM:
Univ Fed Minas Gerais, Fac Med, Dept Internal Med, Belo Horizonte, MG, Brazil
Zakai, NA:
Univ Vermont, Dept Med, Larner Coll Med, Burlington, VT USA
Univ Vermont, Dept Pathol & Lab Med, Larner Coll Med, Burlington, VT USA
Univ Vermont, Med Ctr, Burlington, VT USA
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