American thyroid association guidelines are inconsistent with Grading of Recommendations Assessment, Development, and Evaluations-A meta-epidemiologic study.

Journal of Clinical Epidemiology
Karen Gabriela Bautista-OrdunoRene Rodriguez-Gutierrez

Abstract

The Grading of Recommendations Assessment, Development, and Evaluations (GRADE) working group has recognized some scenarios in which strong recommendations may be supported by low-quality evidence, the so-called paradigmatic situations. The adherence to these paradigmatic situations by the American Thyroid Association (ATA) guidelines, however, remains unknown. Clinical guidelines from the ATA were retrieved and deemed eligible if created using GRADE or the American College of Physicians (ACP) system. Reviewers, independently and in duplicate, assessed all strong recommendations based on low-quality evidence and judged their alignment with GRADE paradigmatic situations. The study was conducted at KER Unit Mexico. A total of five clinical guidelines, one using the GRADE and four using the ACP system, were eligible for analysis. We assessed a total of 518 recommendations, of which 355 (69%) were labeled as "strong" and 163 (31%) as "weak". A total of 151 strong recommendations were based on low-quality evidence, of which 36 (24%) were congruent with one of the five GRADE paradigmatic situations, whereas 115 (76%) were not consistent with any paradigmatic situations and should have been categorized as weak (23% [26/115]) or best-p...Continue Reading

Citations

Sep 10, 2020·Thyroid : Official Journal of the American Thyroid Association·Anna M SawkaJacqueline Jonklaas
Dec 11, 2020·Journal of Clinical Epidemiology·Cord SturgeonUNKNOWN American Thyroid Association Guidelines and Statements Committee

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