Improving the use of research evidence in guideline development: 9. Grading evidence and recommendations.

2.50
Hdl Handle:
http://hdl.handle.net/10143/54613
Title:
Improving the use of research evidence in guideline development: 9. Grading evidence and recommendations.
Authors:
Schünemann, Holger J; Fretheim, Atle; Oxman, Andrew David
Citation:
Health research policy and systems 2006, 4:21
Additional Links:
http://www.health-policy-systems.com/content/4/1/21

Full metadata record

DC FieldValue Language
dc.contributor.authorSchünemann, Holger J-
dc.contributor.authorFretheim, Atle-
dc.contributor.authorOxman, Andrew David-
dc.date.accessioned2009-03-12T11:43:52Z-
dc.date.available2009-03-12T11:43:52Z-
dc.date.issued2006-12-05-
dc.identifier.citationHealth research policy and systems 2006, 4:21en
dc.identifier.issn1478-4505-
dc.identifier.pmid17147810-
dc.identifier.doi10.1186/1478-4505-4-21-
dc.identifier.urihttp://hdl.handle.net/10143/54613-
dc.description.abstractBACKGROUND: The World Health Organization (WHO), like many other organisations around the world, has recognised the need to use more rigorous processes to ensure that health care recommendations are informed by the best available research evidence. This is the ninth of a series of 16 reviews that have been prepared as background for advice from the WHO Advisory Committee on Health Research to WHO on how to achieve this. OBJECTIVES: We reviewed the literature on grading evidence and recommendations in guidelines. METHODS: We searched PubMed and three databases of methodological studies for existing systematic reviews and relevant methodological research. We did not conduct a full systematic review ourselves. Our conclusions are based on the available evidence, consideration of what WHO and other organisations are doing and logical arguments. KEY QUESTIONS AND ANSWERS: Should WHO grade the quality of evidence and the strength of recommendations? Users of recommendations need to know how much confidence they can place in the underlying evidence and the recommendations. The degree of confidence depends on a number of factors and requires complex judgments. These judgments should be made explicitly in WHO recommendations. A systematic and explicit approach to making judgments about the quality of evidence and the strength of recommendations can help to prevent errors, facilitate critical appraisal of these judgments, and can help to improve communication of this information. What criteria should be used to grade evidence and recommendations? Both the quality of evidence and the strength of recommendations should be graded. The criteria used to grade the strength of recommendations should include the quality of the underlying evidence, but should not be limited to that. The approach to grading should be one that has wide international support and is suitable for a wide range of different types of recommendations. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, which is currently suggested in the Guidelines for WHO Guidelines, is being used by an increasing number of other organizations internationally. It should be used more consistently by WHO. Further developments of this approach should ensure its wide applicability. Should WHO use the same grading system for all of its recommendations? Although there are arguments for and against using the same grading system across a wide range of different types of recommendations, WHO should use a uniform grading system to prevent confusion for developers and users of recommendations.en
dc.language.isoenen
dc.relation.urlhttp://www.health-policy-systems.com/content/4/1/21en
dc.subjectVDP::Medisinske Fag: 700::Helsefag: 800::Helsetjeneste- og helseadministrasjonsforskning: 806en
dc.subject.meshPractice Guidelines as Topicen
dc.subject.meshEvidence-Based Medicineen
dc.subject.meshHealth Services Researchen
dc.titleImproving the use of research evidence in guideline development: 9. Grading evidence and recommendations.en
dc.typeJournal articleen
dc.typepeer revieweden
dc.contributor.departmentINFORMA/CLARITY Research Group, S,C, Epidemiologia, Istitituto Regina Elena, Via Elio Chianesi 53, 00144 Rome, Italy. hjs@buffalo.eduen
dc.identifier.journalHealth research policy and systems / BioMed Centralen
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