Grading Quality of Evidence and Strength of Recommendations: A Perspective

Ottawa Methods Centre, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.
PLoS Medicine (Impact Factor: 14.43). 09/2009; 6(9):e1000151. DOI: 10.1371/journal.pmed.1000151
Source: PubMed
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Available from: Alexander Tsertsvadze, Jul 22, 2015
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    • "The development of innovative tools to summarise and synthesise research evidence to support knowledge translation is being put forward as one approach to overcome this research-practice gap (MacFarlane et al, 2011). Although guidelines for presenting evidence for policy makers and health professionals have been developed, for example by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group (Ansari et al, 2009; Guyatt et al, 2008; Owens et al, 2010), publications of empirical studies on the implementation of support tools within knowledge or research institutes are lacking. Addressing this knowledge gap, the aim of the present study is to evaluate the barriers and facilitating factors to the implementation of a tool to facilitate communication on scientific evidence. "
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    ABSTRACT: One of the barriers regarding evidence-informed decision making is the gap between the needs of policy makers and the ways researchers present evidence. This pilot study evaluates the barriers and facilitators to the implementation of a tool to enhance transparent and unambiguous communication on scientific evidence by knowledge workers.Therefore, mixed methods (qualitative and quantitative) were applied.The results indicate that to promote successful implementation of such a tool, efforts should be undertaken to provide time and guidance on how to adapt routines and on how to apply the tool to various products.
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    • "DECIDE will build on the substantial experience and knowledge of the GRADE Working Group. The GRADE Working Group has so far focused on a system for structuring judgements about the quality of evidence and strength of recommendations and there is an emerging consensus around this approach [16,18,20]. In addition, the Working Group has developed and evaluated ways of presenting concise summaries of the findings of systematic reviews (as the basis for recommendations or decisions) to health professionals, and has contributed to ways of presenting this information to guideline developers, policymakers, and patients [21-25,28]. "
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    ABSTRACT: Background Healthcare decision makers face challenges when using guidelines, including understanding the quality of the evidence or the values and preferences upon which recommendations are made, which are often not clear. Methods GRADE is a systematic approach towards assessing the quality of evidence and the strength of recommendations in healthcare. GRADE also gives advice on how to go from evidence to decisions. It has been developed to address the weaknesses of other grading systems and is now widely used internationally. The Developing and Evaluating Communication Strategies to Support Informed Decisions and Practice Based on Evidence (DECIDE) consortium (, which includes members of the GRADE Working Group and other partners, will explore methods to ensure effective communication of evidence-based recommendations targeted at key stakeholders: healthcare professionals, policymakers, and managers, as well as patients and the general public. Surveys and interviews with guideline producers and other stakeholders will explore how presentation of the evidence could be improved to better meet their information needs. We will collect further stakeholder input from advisory groups, via consultations and user testing; this will be done across a wide range of healthcare systems in Europe, North America, and other countries. Targeted communication strategies will be developed, evaluated in randomized trials, refined, and assessed during the development of real guidelines. Discussion Results of the DECIDE project will improve the communication of evidence-based healthcare recommendations. Building on the work of the GRADE Working Group, DECIDE will develop and evaluate methods that address communication needs of guideline users. The project will produce strategies for communicating recommendations that have been rigorously evaluated in diverse settings, and it will support the transfer of research into practice in healthcare systems globally.
    Implementation Science 01/2013; 8(1):6. DOI:10.1186/1748-5908-8-6 · 4.12 Impact Factor
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    • "The Institute of Medicine recently published standards for systematic reviews, which include a standard for interaction between guideline developers and systematic reviewers [27]. Use of an explicit and transparent strategy to evaluate evidence helps users to interpret the relative strength of the evidence [28,29]. Identified studies are systematically appraised by assessing the methodological quality and relevance of the clinical context in the study. "
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    ABSTRACT: Clinical practice and public health guidelines are important tools for translating research findings into practice with the aim of assisting health practitioners as well as patients and consumers in health behavior and healthcare decision-making. Numerous programs for guideline development exist around the world, with growing international collaboration to improve their quality. One of the key features in developing trustworthy guidelines is that recommendations should be based on high-quality systematic reviews of the best available evidence. The review process used by guideline developers to identify and grade relevant evidence for developing recommendations should be systematic, transparent and unbiased. In this paper, we provide an overview of current international developments in the field of practice guidelines and methods to develop guidelines, with a specific focus on the role of systematic reviews. The Guidelines International Network (G-I-N) aims to stimulate collaboration between guideline developers and systematic reviewers to optimize the use of available evidence in guideline development and to increase efficiency in the guideline development process. Considering the significant benefit of systematic reviews for the guideline community, the G-I-N Board of Trustees supports the international prospective register of systematic reviews (PROSPERO) initiative. G-I-N also recently launched a Data Extraction Resource (GINDER) to present and share data extracted from individual studies in a standardized template. PROSPERO and GINDER are complementary tools to enhance collaboration between guideline developers and systematic reviewers to allow for alignment of activities and a reduction in duplication of effort.
    Systematic Reviews 02/2012; 1(1):3. DOI:10.1186/2046-4053-1-3
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