Using evidence to decision frameworks led to guidelines of better quality and more credible and transparent recommendations.

Decision making Evidence-based practice GRADE approach Methods Policy making Practice guidelines

Journal

Journal of clinical epidemiology
ISSN: 1878-5921
Titre abrégé: J Clin Epidemiol
Pays: United States
ID NLM: 8801383

Informations de publication

Date de publication:
Oct 2023
Historique:
received: 30 01 2023
revised: 30 06 2023
accepted: 24 07 2023
pubmed: 31 7 2023
medline: 31 7 2023
entrez: 30 7 2023
Statut: ppublish

Résumé

To determine whether the use of Evidence to Decision (EtD) frameworks is associated to higher quality of both guidelines and individual recommendations. We identified guidelines recently published by international organizations that have methodological guidance documents for their development. Pairs of researchers independently extracted information on the use of these frameworks, appraised the quality of the guidelines using the Appraisal of Guidelines, Research and Evaluation II Instrument (AGREE-II), and assessed the clinical credibility and implementability of the recommendations with the Appraisal of Guidelines for REsearch & Evaluation Recommendations Excellence (AGREE-REX) tool. We conducted both descriptive and inferential analyses. We included 66 guidelines from 17 different countries, published in the last 5 years. Thirty guidelines (45%) used an EtD framework to formulate their recommendations. Compared to those that did not use a framework, those using an EtD framework scored higher in all domains of both AGREE-II and AGREE-REX (P < 0.05). Quality scores did not differ between the use of the The Grading of Recommendations Assessment, Development and Evaluation-EtD framework (17 guidelines) or another EtD framework (13 guidelines) (P > 0.05). The use of EtD frameworks is associated with guidelines of better quality, and more credible and transparent recommendations. Endorsement of EtD frameworks by guideline developing organizations will likely increase the quality of their guidelines.

Sections du résumé

BACKGROUND AND OBJECTIVES OBJECTIVE
To determine whether the use of Evidence to Decision (EtD) frameworks is associated to higher quality of both guidelines and individual recommendations.
METHODS METHODS
We identified guidelines recently published by international organizations that have methodological guidance documents for their development. Pairs of researchers independently extracted information on the use of these frameworks, appraised the quality of the guidelines using the Appraisal of Guidelines, Research and Evaluation II Instrument (AGREE-II), and assessed the clinical credibility and implementability of the recommendations with the Appraisal of Guidelines for REsearch & Evaluation Recommendations Excellence (AGREE-REX) tool. We conducted both descriptive and inferential analyses.
RESULTS RESULTS
We included 66 guidelines from 17 different countries, published in the last 5 years. Thirty guidelines (45%) used an EtD framework to formulate their recommendations. Compared to those that did not use a framework, those using an EtD framework scored higher in all domains of both AGREE-II and AGREE-REX (P < 0.05). Quality scores did not differ between the use of the The Grading of Recommendations Assessment, Development and Evaluation-EtD framework (17 guidelines) or another EtD framework (13 guidelines) (P > 0.05).
CONCLUSION CONCLUSIONS
The use of EtD frameworks is associated with guidelines of better quality, and more credible and transparent recommendations. Endorsement of EtD frameworks by guideline developing organizations will likely increase the quality of their guidelines.

Identifiants

DOI: 10.1016/j.jclinepi.2023.07.013 PMID: 37517506
pubmed: 37517506
pii: S0895-4356(23)00185-3
doi: 10.1016/j.jclinepi.2023.07.013
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

38-46

Informations de copyright

Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare that they have no competing interests. Jose Meneses-Echavez is a doctoral candidate in Public Health and Methodology of Biomedical Research, at the Department of Pediatrics, Obstetrics, Gynecology and Preventive Medicine at Universitat Autonoma de Barcelona, Spain. Pablo Alonso-Coello, Signe Flottorp, and Holger Schünemann were involved in the development of the GRADE-EtD framework. Ivan Dario Florez and Pablo Alonso-Coello were involved in the development of the AGREE-REX tool. Most of the authors are active members of the GRADE Working Group.

Auteurs

Jose F Meneses-Echavez (JF)

Norwegian Institute of Public Health, Oslo, Norway; Facultad de Cultura Física, Deporte y Recreación, Universidad Santo Tomás, Bogotá, Colombia. Electronic address: jose.meneses@fhi.no.

Julia Bidonde (J)

Norwegian Institute of Public Health, Oslo, Norway; School of Rehabilitation Science, College of Medicine, University of Saskatchewan, Saskatoon, Canada.

Camila Montesinos-Guevara (C)

Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC), Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador.

Yasser S Amer (YS)

Clinical Practice Guidelines and Quality Research Unit, Quality Management Department, Pediatrics Department, King Saud University Medical City, Research Chair for Evidence-Based Health Care and Knowledge Translation, King Saud University, Riyadh, Saudi Arabia.

Andres Felipe Loaiza-Betancur (AF)

Instituto Universitario de Educación Física, Universidad de Antioquia, Medellín, Colombia; Grupo de Investigación en Entrenamiento Deportivo y Actividad Física para la Salud (GIEDAF), Universidad Santo Tomás, Tunja, Colombia.

Luis Andres Tellez Tinjaca (LA)

Grupo de Investigación en Entrenamiento Deportivo y Actividad Física para la Salud (GIEDAF), Universidad Santo Tomás, Tunja, Colombia.

David Fraile Navarro (D)

Australian Institute of Health Innovation, Macquarie University, Sydney, Australia; Cochrane Australia, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.

Tina Poklepović Peričić (T)

Department of Research in Biomedicine and Health, University of Split School of Medicine, Split, Croatia.

Ružica Tokalić (R)

Department of Research in Biomedicine and Health, University of Split School of Medicine, Split, Croatia.

Malgorzata M Bala (MM)

Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Systematic Reviews Unit, Jagiellonian University Medical College, Krakow, Poland.

Dawid Storman (D)

Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Systematic Reviews Unit, Department of Adult Psychiatry, University Hospital Jagiellonian University Medical College, Krakow, Poland.

Mateusz Swierz (M)

Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Systematic Reviews Unit, Jagiellonian University Medical College, Krakow, Poland.

Joanna Zając (J)

Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Systematic Reviews Unit, Jagiellonian University Medical College, Krakow, Poland.

Ivan D Flórez (ID)

Department of Pediatrics, University of Antioquia, Calle 67 No. 53-108, Medellin, Colombia; School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada; Pediatric Intensive Care Unit, Clínica Las Américas-AUNA, Medellín, Colombia.

Holger Schünemann (H)

Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.

Signe Flottorp (S)

Norwegian Institute of Public Health, Oslo, Norway; Institute of Health and Society, University of Oslo, Oslo, Norway.

Pablo Alonso-Coello (P)

Iberoamerican Cochrane Centre, CIBERESP-IIB Sant Pau, Barcelona, Spain.

Classifications MeSH