The GRADE evidence-to-decision framework: a report of its testing and application in 15 international guideline panels
Por:
Neumann, I, Brignardello-Petersen, R, Wiercioch, W, Carrasco-Labra, A, Cuello, C, Akl, E, Mustafa, RA, Al-Hazzani, W, Etxeandia-Ikobaltzeta, I, Rojas, MX, Falavigna, M, Santesso, N, Brozek, J, Iorio, A, Alonso-Coello, P, Schunemann, HJ
Publicada:
15 jul 2016
Resumen:
Background: Judgments underlying guideline recommendations are seldom recorded and presented in a systematic fashion. The GRADE Evidence-to-Decision Framework (EtD) offers a transparent way to record and report guideline developers' judgments. In this paper, we report the experiences with the EtD frameworks in 15 real guideline panels.
Methods: Following the guideline panel meetings, we asked methodologists participating in the panel to provide feedback regarding the EtD framework. They were instructed to consider their own experience and the feedback collected from the rest of the panel. Two investigators independently summarized the responses and jointly interpreted the data using pre-specified domains as coding system. We asked methodologists to review the results and provide further input to improve the structure of the EtDs iteratively.
Results: The EtD framework was well received, and the comments were generally positive. Methodologists felt that in a real guideline panel, the EtD framework helps structuring a complex process through relatively simple steps in an explicit and transparent way. However, some sections (e.g., "values and preferences" and "balance between benefits and harms") required further development and clarification that were considered in the current version of the EtD framework.
Conclusions: The use of an EtD framework in guideline development offers a structured and explicit way to record and report the judgments and discussion of guideline panels during the formulation of recommendations. In addition, it facilitates the formulation of recommendations, assessment of their strength, and identifying gaps in research.
Filiaciones:
Neumann, I:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
Pontificia Univ Catolica Chile, Sch Med, Dept Internal Med, Santiago, Chile
Brignardello-Petersen, R:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
Univ Chile, Fac Dent, Evidence Based Dent Unit, Santiago, Chile
Wiercioch, W:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
Carrasco-Labra, A:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
Univ Chile, Fac Dent, Evidence Based Dent Unit, Santiago, Chile
Cuello, C:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
Akl, E:
Amer Univ Beirut, Dept Internal Med, Beirut, Lebanon
Mustafa, RA:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
Univ Missouri Kansas City, Dept Med Nephrol & Biomed & Hlth Informat, Kansas City, MO USA
Al-Hazzani, W:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
Etxeandia-Ikobaltzeta, I:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
Minist Hlth Basque Govt, Basque Off Hlth Technol Assessment OSTEBA, Directorate Hlth Res & Innovat, Vitoria, Spain
Rojas, MX:
Pontificia Univ Javeriana, Fac Med, Dept Clin Epidemiol & Biostat, Bogota, Colombia
Falavigna, M:
Hosp Moinhos Vento, Inst Educ & Res, Porto Alegre, RS, Brazil
Santesso, N:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
Brozek, J:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
McMaster Univ, Dept Clin Epidemiol & Biostat, Hlth Sci Ctr, Room 2C16,1280 Main St West, Hamilton, ON L8S 4K1, Canada
Iorio, A:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
Alonso-Coello, P:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
Biomed Res Inst St Pau IIB St Pau CIBERESP, Iberoamer Cochrane Ctr, Barcelona, Spain
Schunemann, HJ:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
McMaster Univ, Dept Clin Epidemiol & Biostat, Hlth Sci Ctr, Room 2C16,1280 Main St West, Hamilton, ON L8S 4K1, Canada
Gold, Green Published
|