GRADE Evidence to Decision (EtD) frameworks for adoption, adaptation, and de novo development of trustworthy recommendations: GRADE-ADOLOPMENT

Schünemann, Holger J.; Wiercioch, Wojtek; Brožek, Jan; Etxeandia-Ikobaltzeta, Itziar; Mustafa, Reem A.; Manja, Veena; Brignardello‐Petersen, Romina; Neumann, Ignacio; Falavigna, Maicon; Alhazzani, Waleed; Santesso, Nancy; Zhang, Yuan; Meerpohl, Joerg J; Morgan, Rebecca L.; Rochwerg, Bram; Darzi, Andrea; Rojas, Maria Ximenas; Carrasco-Labra, Alonso; Adi, Yaser; AlRayees, Zulfa; Riva, John J.; Bollig, Claudia; Moore, Ainsley; Yepes-Núñez, Juan José; Cuello-Garcia, Carlos A.; Waziry, Reem; Akl, Elie A.

doi:10.1016/j.jclinepi.2016.09.009

Cited by 414 publications

(570 citation statements)

References 23 publications

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“…We used the principles outlined in the evidence to decision framework (EtD) to formulate recommendations, but because of the tight timelines we did not complete the online EtD tables [11]. The EtD framework covers the following domains: priority setting, magnitude of benefit and harm, certainty of the evidence, patient values, balance between desirable and undesirable effects, resources and cost, equity, acceptability and feasibility.…”

Section: Recommendation Formulationmentioning

confidence: 99%

Surviving Sepsis Campaign: guidelines on the management of critically ill adults with Coronavirus Disease 2019 (COVID-19)

et al. 2020

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Background: The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of a rapidly spreading illness, Coronavirus Disease 2019 (COVID-19), affecting thousands of people around the world. Urgent guidance for clinicians caring for the sickest of these patients is needed. Methods:We formed a panel of 36 experts from 12 countries. All panel members completed the World Health Organization conflict of interest disclosure form. The panel proposed 53 questions that are relevant to the management of COVID-19 in the ICU. We searched the literature for direct and indirect evidence on the management of COVID-19 in critically ill patients in the ICU. We identified relevant and recent systematic reviews on most questions relating to supportive care. We assessed the certainty in the evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, then generated recommendations based on the balance between benefit and harm, resource and cost implications, equity, and feasibility. Recommendations were either strong or weak, or in the form of best practice recommendations. Results:The Surviving Sepsis Campaign COVID-19 panel issued 54 statements, of which 4 are best practice statements, 9 are strong recommendations, and 35 are weak recommendations. No recommendation was provided for 6 questions. The topics were: (1) infection control, (2) laboratory diagnosis and specimens, (3) hemodynamic support, (4) ventilatory support, and (5) COVID-19 therapy.Recommendation 9. For the acute resuscitation of adults with COVID-19 and shock, we suggest using a conservative over a liberal fluid strategy. Weak recommendation, low-quality evidence.

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Section: Recommendation Formulationmentioning

confidence: 99%

Surviving Sepsis Campaign: guidelines on the management of critically ill adults with Coronavirus Disease 2019 (COVID-19)

et al. 2020

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“…The AGREE II framework 15 was used to guide development, and recognising the expediency of this work required pragmatic and transparent reporting. Conduct was modelled after the GRADE Adolopment Process 16 and Evidence to Decision framework 17 Through a web search and personal files, recently developed guidelines for COVID-19 management of critically ill patients were identified from international agencies (eg, World Health Organization), critical care professional societies or groups (eg, Australia and New Zealand Intensive Care Society, Society of Critical Care Medicine/ European Society of Intensive Care Medicine), or physiotherapy professional societies up to 21 March 2020. These guidelines were used to inform the consensus recommendations developed in conjunction with expert opinion of the authorship group.…”

Section: Consensus Approachmentioning

confidence: 99%

Physiotherapy management for COVID-19 in the acute hospital setting: clinical practice recommendations

Thomas

Baldwin

Bissett

et al. 2020

Journal of Physiotherapy

601

641

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“…The Canadian guidelines combine recommendations for physical activity, sedentary behaviour and sleep for a 24-h period rather than a set of segregated guidelines [12]. Several countries have followed this trend towards 24-h movement guidelines, with New Zealand adopting the Canadian guidelines and Australia 'adoloping' the guidelines [64]. Importantly future systematic reviews of physical activity guidelines should incorporate '24-h movement' and associated variations into the search terms to ensure these guidelines are not omitted.…”

Section: Discussionmentioning

confidence: 99%

“…Notably the overall AGREE II score for the WHO guideline development was higher than 90% (and will soon be revised). In instances where countries are not able to provide the same level of quality, it is recommended that the WHO Guidelines be used or the GRADE-ADOLOPMENT approach be followed [64].…”

Section: Discussionmentioning

confidence: 99%

Comparing and assessing physical activity guidelines for children and adolescents: a systematic literature review and analysis

Parrish

Tremblay

Carson

et al. 2020

Int J Behav Nutr Phys Act

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Background The impact of declining physical activity and increased sedentary behaviour in children and adolescents globally prompted the development of national and international physical activity guidelines. This research aims to systematically identify and compare national and international physical activity guidelines for children and adolescents and appraise the quality of the guidelines to promote best practice in guideline development. Methods This systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Only national, or international physical activity and/or sedentary behaviour guidelines were included in the review. Included guidelines targeted children and adolescents aged between 5 and 18 years. A grey literature search was undertaken incorporating electronic databases, custom Google search engines, targeted websites and international expert consultation. Guideline quality was assessed using the Appraisal of Guidelines for Research and Evaluation II Instrument (AGREE II). Results The search resulted in 50 national or international guidelines being identified. Twenty-five countries had a national guideline and there were three international guidelines (European Union, Nordic countries (used by Iceland, Norway and Sweden), World Health Organization (WHO)). Nineteen countries and the European Union adopted the WHO guidelines. Guidelines varied in relation to date of release (2008 to 2019), targeted age group, and guideline wording regarding: type, amount, duration, intensity, frequency and total amount of physical activity. Twenty-two countries included sedentary behaviour within the guidelines and three included sleep. Total scores for all domains of the AGREE II assessment for each guideline indicated considerable variability in guideline quality ranging from 25.8 to 95.3%, with similar variability in the six individual domains. Rigorous guideline development is essential to ensure appropriate guidance for population level initiatives. Conclusions This review revealed considerable variability between national/international physical activity guideline quality, development and recommendations, highlighting the need for rigorous and transparent guideline development methodologies to ensure appropriate guidance for population-based approaches. Where countries do not have the resources to ensure this level of quality, the adoption or adolopment (framework to review and update guidelines) of the WHO guidelines or guidelines of similar quality is recommended. Trial registration Review registration: PROSPERO 2017 CRD42017072558.

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GRADE Evidence to Decision (EtD) frameworks for adoption, adaptation, and de novo development of trustworthy recommendations: GRADE-ADOLOPMENT

Abstract: The "GRADE-ADOLOPMENT" approach to guideline production combines adoption, adaptation, and, as needed, de novo development of recommendations. If developers of guidelines follow EtD criteria more widely and make their work publically available, this approach should prove even more useful.

Cited by 414 publications

References 23 publications

Surviving Sepsis Campaign: guidelines on the management of critically ill adults with Coronavirus Disease 2019 (COVID-19)

Surviving Sepsis Campaign: guidelines on the management of critically ill adults with Coronavirus Disease 2019 (COVID-19)

Physiotherapy management for COVID-19 in the acute hospital setting: clinical practice recommendations

Comparing and assessing physical activity guidelines for children and adolescents: a systematic literature review and analysis

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