GRADE guidelines: 11. Making an overall rating of confidence in effect estimates for a single outcome and for all outcomes

Guyatt, Gordon; Oxman, Andrew D; Sultan, Shahnaz; Brožek, Jan; Glasziou, Paul; Alonso‐Coello, Pablo; Atkins, David C.; Kunz, Regina; Montori, Víctor M.; Jaeschke, Roman; Rind, David M.; Dahm, Philipp; Akl, Elie A.; Meerpohl, Joerg J; Vist, Gunn Elisabeth; Berliner, Elise; Norris, Susan L.; Falck‐Ytter, Yngve; Schünemann, Holger J.

doi:10.1016/j.jclinepi.2012.01.006

Cited by 603 publications

(316 citation statements)

References 13 publications

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“…28 These critical outcomes are prescription of asthma controller medicines, provision of asthma action plan/self-management education, ED visits/hospitalizations, and missed days of school or work. 29 …”

Section: Study Selectionmentioning

confidence: 99%

Interventions to Modify Health Care Provider Adherence to Asthma Guidelines: A Systematic Review

Butz²,

et al. 2013

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BACKGROUND AND OBJECTIVE: Health care provider adherence to asthma guidelines is poor. The objective of this study was to assess the effect of interventions to improve health care providers' adherence to asthma guidelines on health care process and clinical outcomes. RESULTS: Sixty-eight eligible studies were classified by intervention: decision support, organizational change, feedback and audit, clinical pharmacy support, education only, quality improvement/pay-forperformance, multicomponent, and information only. Half were randomized trials (n = 35). There was moderate evidence for increased prescriptions of controller medications for decision support, feedback and audit, and clinical pharmacy support and low-grade evidence for organizational change and multicomponent interventions. Moderate evidence supports the use of decision support and clinical pharmacy interventions to increase provision of patient self-education/asthma action plans. Moderate evidence supports use of decision support tools to reduce emergency department visits, and low-grade evidence suggests there is no benefit for this outcome with organizational change, education only, and quality improvement/pay-for-performance. METHODS:CONCLUSIONS: Decision support tools, feedback and audit, and clinical pharmacy support were most likely to improve provider adherence to asthma guidelines, as measured through health care process outcomes. There is a need to evaluate health care provider-targeted interventions with standardized outcomes. Pediatrics 2013;132:517-534

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Section: Study Selectionmentioning

confidence: 99%

Interventions to Modify Health Care Provider Adherence to Asthma Guidelines: A Systematic Review

Butz²,

et al. 2013

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“…It assessed a body of evidence by referring to the concepts of the GRADE system (Ref. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]; Table 4), and determined and recorded the quality of a body of evidence for each CQ (Table 5).…”

Section: Systematic Review Methodology (Assessment Of a Body Of Evidementioning

confidence: 99%

JSGE Clinical Practice Guidelines 2014: standards, methods, and process of developing the guidelines

et al. 2014

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“…[3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] The most recent papers, published in 2013, detail the process of using GRADE to determine the strength of recommendations. 16,17 In late 2010 the GRADE Working Group also published a list of criteria that must be met for full GRADE compliance, 18 summarized here:…”

Section: The I M Petus Fo R a Nother Updatementioning

confidence: 99%

The Evolution of the AASM Clinical Practice Guidelines: Another Step Forward

Morgenthaler

Deriy

Heald

et al. 2016

Journal of Clinical Sleep Medicine

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One of the goals of the American Academy of Sleep Medicine (AASM) is to provide clear, evidence-based recommendations in our clinical practice guidelines. Periodically, the AASM will assess and update the process by which these guidelines are developed so that it is in line with the standards currently being used for guideline development. The AASM is now taking the next step forward by fully adopting GRADE (Grading of Recommendation Assessment, Development and Evaluation) as the methodology used for evaluating evidence and forming clinical practice guidelines recommendations. Starting this year, AASM recommendations will be based on the following four interdependent domains: 1. quality of evidence; 2. balance of desirable and undesirable consequences; 3. patients' values and preferences; and 4. resource use (when known). AASM strengths of recommendations will be dichotomized into two categories: "Strong" and "Weak," either for or against a patient-care strategy. In an effort to provide clarity and transparency, all AASM recommendations will be actionable statements that include the specific patient population for which the patient-care strategy is recommended, and clearly define the comparator against which the patient-care strategy was evaluated. In some recommendations, the comparator will be an alternative patient-care strategy (e.g., a "gold standard" or previously available alternative), while in other recommendations the comparator will be a placebo or no treatment; this is determined by the availability of evidence, and analyses decisions made by the AASM task force. Implementation of the complete GRADE criteria by the AASM allows us the best path forward towards continuing to provide high quality clinical practice guidelines. I NTRO DUCTI O NAmerican Academy of Sleep Medicine clinical practice guidelines (and the prior Practice Parameters and Best Practice Guides) are developed to bring the fruits of clinical and basic research into practice, offering guidance to practicing sleep specialists and other health care professionals who work with patients and families who suffer from sleep disorders. These guidelines have influenced clinical practice in the office and at the bedside, on a national and international level. It is therefore imperative that the very best efforts and techniques be applied to produce guidelines that are accurate, clear, and reliable. This document will describe some recent evolutionary changes to how recommendations will be developed by the AASM and how they will appear in AASM clinical practice guidelines, beginning this year.In 2009, the AASM began adopting GRADE (Grading of Recommendations Assessment, Development, and Evaluation) as the methodology for evaluating evidence and forming clinical practice guideline recommendations.1 The major impetus for this change was that, compared to the prior employed methodologies which heavily emphasized study design, GRADE placed weight on the systematic evaluation of a wider spectrum of characteristics of the evidence (e.g., not only study...

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GRADE guidelines: 11. Making an overall rating of confidence in effect estimates for a single outcome and for all outcomes

Cited by 603 publications

References 13 publications

Interventions to Modify Health Care Provider Adherence to Asthma Guidelines: A Systematic Review

Interventions to Modify Health Care Provider Adherence to Asthma Guidelines: A Systematic Review

JSGE Clinical Practice Guidelines 2014: standards, methods, and process of developing the guidelines

The Evolution of the AASM Clinical Practice Guidelines: Another Step Forward

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