Evidence to Decision framework provides a structured “roadmap” for making GRADE guidelines recommendations

Li, Shelly‐Anne; Alexander, Paul; Reljic, Tea; Cuker, Adam; Nieuwlaat, Robby; Wiercioch, Wojtek; Guyatt, Gordon; Djulbegoviĉ, Benjamin

doi:10.1016/j.jclinepi.2018.09.007

Cited by 35 publications

(42 citation statements)

References 39 publications

(50 reference statements)

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“…All members of the working group individually reviewed the narrative synthesis of the literature and the tabular synthesis of drug-drug interactions, and subsequently, collegial discussions were organized electronically. The discussion was moderated in order to appraise the available evidence in light of possible values and preferences, clinical expertise considerations, certainty of the evidence retrieve, and feasibility issues, according to the GRADE Evidence-to-Decision Framework [104]. Following discussion, the working group formulated practical recommendations for clinicians.…”

Section: Methodsmentioning

confidence: 99%

Safety of psychotropic medications in people with COVID-19: evidence review and practical recommendations

Ostuzzi

Papola

Gastaldon

et al. 2020

BMC Med

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Background The novel coronavirus pandemic calls for a rapid adaptation of conventional medical practices to meet the evolving needs of such vulnerable patients. People with coronavirus disease (COVID-19) may frequently require treatment with psychotropic medications, but are at the same time at higher risk for safety issues because of the complex underlying medical condition and the potential interaction with medical treatments. Methods In order to produce evidence-based practical recommendations on the optimal management of psychotropic medications in people with COVID-19, an international, multi-disciplinary working group was established. The methodology of the WHO Rapid Advice Guidelines in the context of a public health emergency and the principles of the AGREE statement were followed. Available evidence informing on the risk of respiratory, cardiovascular, infective, hemostatic, and consciousness alterations related to the use of psychotropic medications, and drug–drug interactions between psychotropic and medical treatments used in people with COVID-19, was reviewed and discussed by the working group. Results All classes of psychotropic medications showed potentially relevant safety risks for people with COVID-19. A set of practical recommendations was drawn in order to inform frontline clinicians on the assessment of the anticipated risk of psychotropic-related unfavorable events, and the possible actions to take in order to effectively manage this risk, such as when it is appropriate to avoid, withdraw, switch, or adjust the dose of the medication. Conclusions The present evidence-based recommendations will improve the quality of psychiatric care in people with COVID-19, allowing an appropriate management of the medical condition without worsening the psychiatric condition and vice versa.

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Section: Methodsmentioning

confidence: 99%

Safety of psychotropic medications in people with COVID-19: evidence review and practical recommendations

Ostuzzi

Papola

Gastaldon

et al. 2020

BMC Med

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“…The expert panel, in collaboration with a team of methodologists, prioritized and developed six questions that addressed significant COPD management issues. These questions were rephrased by the methods team using the Population, Intervention, Comparator, and Outcomes (PICO) format, and panel members then compiled and prioritized a list of outcomes that were important for clinical decision-making and particularly important to patients (2,3). Evidence syntheses for each PICO question were focused on clinical outcomes deemed "critical" for clinical decision-making.…”

Section: Introductionmentioning

confidence: 99%

Pharmacologic Management of Chronic Obstructive Pulmonary Disease. An Official American Thoracic Society Clinical Practice Guideline

Nici

Mammen

Charbek

et al. 2020

Am J Respir Crit Care Med

Self Cite

215

245

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Background: This document provides clinical recommendations for the pharmacologic treatment of chronic obstructive pulmonary disease (COPD). It represents a collaborative effort on the part of a panel of expert COPD clinicians and researchers along with a team of methodologists under the guidance of the American Thoracic Society. Methods: Comprehensive evidence syntheses were performed on all relevant studies that addressed the clinical questions and critical patient-centered outcomes agreed upon by the panel of experts. The evidence was appraised, rated, and graded, and recommendations were formulated using the Grading of Recommendations, Assessment, Development, and Evaluation approach. Conclusions: The task force made recommendations regarding the pharmacologic treatment of COPD based on currently available evidence. Additional research in populations that are underrepresented in clinical trials is needed, including studies in patients with COPD 80 years of age and older, those with multiple chronic health conditions, and those with a codiagnosis of COPD and asthma.

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“…Data extracted from included studies are available in File S2. [38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53] vealed that the best approach was unknown. 47 Of the remaining 14 studies, 6 (42.9%) identified patient preferences for the purpose of guideline development, [40][41][42]49,50,53 and 10 (71.4%) explored various methods for doing so.…”

Section: Search Resultsmentioning

confidence: 99%

How to identify, incorporate and report patient preferences in clinical guidelines: A scoping review

Kim

Armstrong

Berta

et al. 2020

Health Expectations

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Background Clinical guidelines optimize care delivery and outcomes. Guidelines support patient engagement and adherence if they reflect patient preferences for treatment options, risks and benefits. Many guidelines do not address patient preferences. Developers require insight on how to develop such guidelines. Objective To conduct a scoping review on how to identify, incorporate and report patient preferences in guidelines. Search We searched MEDLINE, EMBASE, Scopus, CINAHL, OpenGrey and GreyLit from 2010 to November 2019. Eligibility We included English language studies describing patient preferences and guidelines. Data extraction and synthesis We reported approaches for and determinants and impacts of identifying patient preferences using summary statistics and text, and interpreted findings using a conceptual framework of patient engagement in guideline development. Results Sixteen studies were included: 2 consulted patients and providers about patient engagement approaches, and 14 identified patient preferences (42.9%) or methods for doing so (71.4%). Studies employed single (57.1%) or multiple (42.9%) methods for identifying preferences. Eight (57.1%) incorporated preferences in one aspect of guideline development, while 6 (42.9%) incorporated preferences in multiple ways, most commonly to identify questions, benefits or harms, and generate recommendations. Studies did not address patient engagement in many guideline development steps. Included studies were too few to establish the best approaches for identifying or incorporating preferences. Fewer than half of the studies (7, 43.8%) explored barriers. None examined reporting preferences in guidelines. Conclusions Research is needed to establish the single or multiple approaches that result in incorporating and reporting preferences in all guideline development steps.

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Evidence to Decision framework provides a structured “roadmap” for making GRADE guidelines recommendations

Cited by 35 publications

References 39 publications

Safety of psychotropic medications in people with COVID-19: evidence review and practical recommendations

Safety of psychotropic medications in people with COVID-19: evidence review and practical recommendations

Pharmacologic Management of Chronic Obstructive Pulmonary Disease. An Official American Thoracic Society Clinical Practice Guideline

How to identify, incorporate and report patient preferences in clinical guidelines: A scoping review

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