Using GRADE evidence to decision frameworks to choose from multiple interventions

Piggott, Thomas; Brožek, Jan; Nowak, Artur; Dietl, Helena; Dietl, Bart; Saz‐Parkinson, Zuleika; Mirzayev, Fuad; González-Angulo, Licé; Yepes-Núñez, Juan José; Mustafa, Reem A.; Leontiadis, Grigorios I; Brignardello‐Petersen, Romina; Alonso‐Coello, Pablo

doi:10.1016/j.jclinepi.2020.10.016

Cited by 18 publications

(21 citation statements)

References 12 publications

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“… GRADE Evidence to Decision (EtD) frameworks. 121 , 122 Panel education, for example, INGUIDE (International Guideline Development Credentialling & Certification Programme, a comprehensive, evidence‐based, and up‐to‐date training programme for guideline recommendation and development) ( https://inguide.org ). …”

Section: Implications Of Direct Patient Mask‐air ® ...mentioning

confidence: 99%

“…The NextGen ARIA guidelines 2023 will be developed with real patient data, analysis of new data and new methods facilitating the process of prioritising questions and health outcomes in guideline development. This will support the creation of trustworthy guidelines following a structured plan (in collaboration with HJ Schünemann and J Brozek): 116–120 Question prioritisation including, if possible, (i) differentiation between rhinitis and asthma + rhinitis, (ii) comedication and (iii) AIT. Evidence‐based analysis including meta‐analyses. Integration of direct patient data including MASK‐air ® . GRADE Evidence to Decision (EtD) frameworks 121,122 Panel education, for example, INGUIDE (International Guideline Development Credentialling & Certification Programme, a comprehensive, evidence‐based, and up‐to‐date training programme for guideline recommendation and development) (https://inguide.org).…”

Section: Implications Of Direct Patient Mask‐air® Data and Research N...mentioning

confidence: 99%

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Digitally‐enabled, patient‐centred care in rhinitis and asthma multimorbidity: The ARIA‐MASK‐air^®approach

Bousquet

Antó

Sousa‐Pinto

et al. 2023

Clinical & Translational All

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MASK‐air ® , a validated mHealth app (Medical Device regulation Class IIa) has enabled large observational implementation studies in over 58,000 people with allergic rhinitis and/or asthma. It can help to address unmet patient needs in rhinitis and asthma care. MASK‐air ® is a Good Practice of DG Santé on digitally‐enabled, patient‐centred care. It is also a candidate Good Practice of OECD (Organisation for Economic Co‐operation and Development). MASK‐air ® data has enabled novel phenotype discovery and characterisation, as well as novel insights into the management of allergic rhinitis. MASK‐air ® data show that most rhinitis patients (i) are not adherent and do not follow guidelines, (ii) use as‐needed treatment, (iii) do not take medication when they are well, (iv) increase their treatment based on symptoms and (v) do not use the recommended treatment. The data also show that control (symptoms, work productivity, educational performance) is not always improved by medications. A combined symptom‐medication score (ARIA‐EAACI‐CSMS) has been validated for clinical practice and trials. The implications of the novel MASK‐air ® results should lead to change management in rhinitis and asthma.

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Section: Implications Of Direct Patient Mask‐air ® ...mentioning

confidence: 99%

Section: Implications Of Direct Patient Mask‐air® Data and Research N...mentioning

confidence: 99%

Digitally‐enabled, patient‐centred care in rhinitis and asthma multimorbidity: The ARIA‐MASK‐air^®approach

Bousquet

Antó

Sousa‐Pinto

et al. 2023

Clinical & Translational All

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“…Due to distinct purpose and focus in appraising applicability, the complexity of frameworks and the number, nature, and level of criteria detail within frameworks also varied. Some frameworks featured a simple list of key criteria [ 50 , 53 ] whereas others elaborated on a full system of domains, criteria, and appraisal processes (e.g., RE-AIM [ 22 , 44 ], GRADE [ 11 ], PRECIS [ 41 ], RoB2 [ 7 ], RoBINS-I [ 56 ], Atkins et al [ 48 ]); some adapted to specific concepts and disciplines (GRADE EtD) [ 18 , 34 – 38 ]. After comparative analysis of frameworks, we identified three dimensions explaining the variability which we used to map the frameworks and criteria: The primary intended target user or stakeholders (researchers, clinicians, and decision-makers); The evidence type appraised and its level of aggregation, from fundamental research to CPG; The areas of applicability: internal validity, clinical applicability for individual patients, external validity, and applicability at the system level.…”

Section: Resultsmentioning

confidence: 99%

Appraising clinical applicability of studies: mapping and synthesis of current frameworks, and proposal of the FrACAS framework and VICORT checklist

Nguyên

Moodie

Desmarais

et al. 2021

BMC Med Res Methodol

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Background Not all research findings are translated to clinical practice. Reasons for lack of applicability are varied, and multiple frameworks and criteria exist to appraise the general applicability of epidemiological and clinical research. In this two-part study, we identify, map, and synthesize frameworks and criteria; we develop a framework to assist clinicians to appraise applicability specifically from a clinical perspective. Methods We conducted a literature search in PubMed and Embase to identify frameworks appraising applicability of study results. Conceptual thematic analysis was used to synthesize frameworks and criteria. We carried out a framework development process integrating contemporary debates in epidemiology, findings from the literature search and synthesis, iterative pilot-testing, and brainstorming and consensus discussions to propose a concise framework to appraise clinical applicability. Results Of the 4622 references retrieved, we identified 26 unique frameworks featuring 21 criteria. Frameworks and criteria varied by scope and level of aggregation of the evidence appraised, target user, and specific area of applicability (internal validity, clinical applicability, external validity, and system applicability). Our proposed Framework Appraising the Clinical Applicability of Studies (FrACAS) classifies studies in three domains (research, practice informing, and practice changing) by examining six criteria sequentially: Validity, Indication-informativeness, Clinical relevance, Originality, Risk-benefit comprehensiveness, and Transposability (VICORT checklist). Conclusions Existing frameworks to applicability vary by scope, target user, and area of applicability. We introduce FrACAS to specifically assess applicability from a clinical perspective. Our framework can be used as a tool for the design, appraisal, and interpretation of epidemiological and clinical studies.

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“…Even this guideline could be criticized for its failure to adequately involve patients as stakeholders and the brevity of the economic analysis. In addition to the AGREE instrument another standard for guidelines is GRADE methodology for appraising level of evidence [32,33]. This was absent in the majority of guidelines.…”

Section: Discussionmentioning

confidence: 99%

Guidelines, guidelines and more guidelines for haemorrhoid treatment: A review to sort the wheat from the chaff

et al. 2022

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Aim Guidelines benefit patients and clinicians by distilling evidence into easy‐to‐read recommendations. The literature around the management of haemorrhoids is immense and guidelines are invaluable to improve treatment integrity and patient outcomes. We identified current haemorrhoid guidelines and assessed them for quality and consistency. Methods A systematic search of the literature from January 2011 to October 2021 was carried out. Guidelines identified were assessed for quality using the AGREE II instrument and for consistency in terms of tabulated treatment recommendations. Results During this period nine guidelines were identified worldwide. The general quality was poor with only one guideline considered of high enough quality for use. In general, expert selection criteria for guideline development groups were vaguely defined. There were inconsistencies in the interpretation of the published evidence leading to variation in treatment recommendations. Discussion Fewer, higher quality guidelines, with more consistent results, are needed. Particular attention should be given to defining the selection of experts involved.

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Using GRADE evidence to decision frameworks to choose from multiple interventions

Cited by 18 publications

References 12 publications

Digitally‐enabled, patient‐centred care in rhinitis and asthma multimorbidity: The ARIA‐MASK‐air^®approach

Digitally‐enabled, patient‐centred care in rhinitis and asthma multimorbidity: The ARIA‐MASK‐air^®approach

Appraising clinical applicability of studies: mapping and synthesis of current frameworks, and proposal of the FrACAS framework and VICORT checklist

Guidelines, guidelines and more guidelines for haemorrhoid treatment: A review to sort the wheat from the chaff

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Using GRADE evidence to decision frameworks to choose from multiple interventions

Cited by 18 publications

References 12 publications

Digitally‐enabled, patient‐centred care in rhinitis and asthma multimorbidity: The ARIA‐MASK‐air®approach

Digitally‐enabled, patient‐centred care in rhinitis and asthma multimorbidity: The ARIA‐MASK‐air®approach

Appraising clinical applicability of studies: mapping and synthesis of current frameworks, and proposal of the FrACAS framework and VICORT checklist

Guidelines, guidelines and more guidelines for haemorrhoid treatment: A review to sort the wheat from the chaff

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Product

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Digitally‐enabled, patient‐centred care in rhinitis and asthma multimorbidity: The ARIA‐MASK‐air^®approach

Digitally‐enabled, patient‐centred care in rhinitis and asthma multimorbidity: The ARIA‐MASK‐air^®approach