1 / 18

GDG Meeting Wednesday November 9, 2011 9:30 – 11:30 am

GDG Meeting Wednesday November 9, 2011 9:30 – 11:30 am. Agenda. Objectives. Confirm outcomes for analytic framework Review Guideline Development Process Review rationale and purpose of GRADE Review a sample GRADE table to ensure everyone is comfortable using them. GRADE: An Overview.

luz
Download Presentation

GDG Meeting Wednesday November 9, 2011 9:30 – 11:30 am

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. GDG MeetingWednesday November 9, 2011 9:30 – 11:30 am

  2. Agenda

  3. Objectives • Confirm outcomes for analytic framework • Review Guideline Development Process • Review rationale and purpose of GRADE • Review a sample GRADE table to ensure everyone is comfortable using them

  4. GRADE: An Overview Grading of Recommendations Assessment, Development and Evaluation

  5. Agenda • What is GRADE? • Importance of Evidence • Determining Quality of Evidence • Methods for Summarizing Evidence • Evidence Profile Tables • Summary of Findings Tables • Determining Strength of Recommendations

  6. What is GRADE? • A transparent and structured process for developing and presenting evidence summaries for systematic reviews and guidelines in health care and for carrying out the steps involved in developing recommendations.

  7. The GRADE Approach • Considers • All factors to determine how confident we are in the results (quality of evidence) • The evidence for each outcome • Magnitude of the effect • Ensures • Systematic process • Transparency

  8. Importance of Evidence When making guideline recommendations: • The quality of evidence reflects the extent to which our confidence in an estimate of the effect is adequate to support a particular recommendation.

  9. Quality of the Body of Evidence

  10. Determining Quality • RCTs start  (high) • Observational studies start at  (low)

  11. Determining Quality 5 factors that can lower quality • Limitations in detailed design and execution (risk of bias criteria) • Inconsistency (or heterogeneity) • Indirectness (PICO and applicability) • Imprecision (number of events and confidence intervals) • Publication bias

  12. Summarizing Evidence • Evidence Profiles and Summary of Findings Tables • An EP includes a detailed quality assessment in addition to a SoFs. • The SoF table includes an assessment of the quality of evidence for each outcome but not the detailed judgments on which that assessment is based.

  13. Evidence Profile Table

  14. Summary of Findings Table

  15. Determining Strength of Recommendations

  16. 4 key Factors Influence the Strength of a Recommendation 1. Quality of the evidence • The higher the quality of evidence, the more likely is a strong recommendation. 2. Balance between desirable and undesirable effects • The larger the difference between the desirable and undesirable consequences, the more likely a strong recommendation warranted. The smaller the net benefit and the lower certainty for that benefit, the more likely weak recommendation warranted. 3. Values and preferences • The greater the variability in values and preferences, or uncertainty in values and preferences, the more likely weak recommendation warranted. 4. Costs (resource allocation) • The higher the costs of an intervention – that is, the more resources consumed – the less likely is a strong recommendation warranted

More Related