Artículo de revista
The GRADE evidence-to-decision framework: A report of its testing and application in 15 international guideline panels
Fecha
2016Registro en:
Implementation Science, Volumen 11, Issue 1, 2016, Pages 1-8.
17485908
10.1186/s13012-016-0462-y
Autor
Neumann, Ignacio
Brignardello Petersen, Romina
Wiercioch, Wojtek
Carrasco Labra, Alonso
Cuello, Carlos
Akl, Elie A
Mustafa, Reem
Al-Hazzani, Waleed
Etxeandia-Ikobaltzeta, Itziar
Rojas, María
Falavigna, Maicon
Santesso, Nancy
Brozek, Jan
Iorio, Alf
Alonso-Coello, Pablo
Schünemann, Holger
Institución
Resumen
Background: Judgments underlying guideline recommendations are seldom recorded and presented in a
systematic fashion. The GRADE Evidence-to-Decision Framework (EtD) offers a transparent way to record and report
guideline developers’ judgments. In this paper, we report the experiences with the EtD frameworks in 15 real
guideline panels.
Methods: Following the guideline panel meetings, we asked methodologists participating in the panel to provide
feedback regarding the EtD framework. They were instructed to consider their own experience and the feedback
collected from the rest of the panel. Two investigators independently summarized the responses and jointly
interpreted the data using pre-specified domains as coding system. We asked methodologists to review the results
and provide further input to improve the structure of the EtDs iteratively.
Results: The EtD framework was well received, and the comments were generally positive. Methodologists felt that
in a real guideline panel, the EtD framework helps structuring a complex process through relatively simple steps in
an explicit and transparent way. However, some sections (e.g., “values and preferences” and “balance between
benefits and harms”) required further development and clarification that were considered in the current version of
the EtD framework.
Conclusions: The use of an EtD framework in guideline development offers a structured and explicit way to record
and report the judgments and discussion of guideline panels during the formulation of recommendations. In
addition, it facilitates the formulation of recommendations, assessment of their strength, and identifying gaps in
research.