gms | German Medical Science

G-I-N Conference 2012

Guidelines International Network

22.08 - 25.08.2012, Berlin

What does GRADE bring to the table – confusion or clarity?

Meeting Abstract

  • E. Newbatt - National Collaborating Centre for Women's and Children's Health, London, UK
  • Z. Beckles - National Collaborating Centre for Women's and Children's Health, London, UK
  • K. Kelley - NCGC, London, UK
  • H. McGuire - National Collaborating Centre for Women's and Children's Health, London, UK
  • R. Ullman - National Collaborating Centre for Women's and Children's Health, London, UK

Guidelines International Network. G-I-N Conference 2012. Berlin, 22.-25.08.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocO39

DOI: 10.3205/12gin071, URN: urn:nbn:de:0183-12gin0716

Published: July 10, 2012

© 2012 Newbatt et al.
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Outline

Text

Background: The National Institute for Health and Clinical Excellence (NICE) commissions four National Collaborating Centres (NCCs) to produce clinical guidelines in the UK. NICE has adopted GRADE methodology for appraising the quality of evidence underlying recommendations. However, questions remain about how best to present evidence to guideline development groups (GDGs) for discussion.

Objectives: To determine how each NCC presents evidence and to explore whether this affects how GDGs interpret evidence and make recommendations.

Methods: NCCs were surveyed by email and GDG members using an online questionnaire.

Results: Three NCCs responded, and reported using the following when presenting evidence: GRADE profiles (15 guidelines across two NCCs); Summary tables, incorporating parts of a GRADE profile (4 guidelines in one NCC); Forest plots (5 guidelines in one NCC). After stratification into healthcare professionals and patient representatives, GDG members were randomized to receive 6 case scenarios with evidence presented in one of the above formats, and asked to choose recommendations. Participants were also asked about how they prefer to read evidence and to comment on the clarity of the evidence presented.

Results of the GDG questionnaire will be presented at G-I-N 2012.

Discussion/Implications for guideline developers: Despite the adoption of GRADE profiles in UK clinical guidelines, each NCC presents evidence to GDGs differently. An understanding of how GDGs interpret different forms of evidence is critical to facilitating the development of evidence-based recommendations; therefore, the results of this study are applicable to guideline developers worldwide.