Quality of evidence is a key determinant for making a strong GRADE guidelines recommendation

Journal of Clinical Epidemiology
Benjamin DjulbegovicGordon H Guyatt

Abstract

The objective of the study was to assess the association between Grading of Recommendations Assessment, Development and Evaluation (GRADE) factors and the strength of recommendations. The study was conducted as part of the development of clinical practice guideline (CPG) by American Association of Blood Banking related to role of prophylactic vs. therapeutic transfusion for the management of thrombocytopenia. The association between GRADE factors and strength of recommendations was assessed using logistic regression and multilevel mixed effect logistic regression model. Seventeen members of the CPG panel participated in the recommendation process. The quality of evidence was the only statistically significant (odds ratio = 4.5; P < 0.001) GRADE factor associated with the strength of recommendations. The predictive model showed that there is about 90% probability that panelists would issue the same (strong) recommendation when confidence in the effects of intervention is high vs. 10% when the quality of evidence is very low. The results showed that quality of evidence is a key determinant for making a strong vs. a weak recommendation.

References

Apr 26, 2008·BMJ : British Medical Journal·Gordon H GuyattUNKNOWN GRADE Working Group
Jul 23, 2009·BMC Health Services Research·Benjamin DjulbegovicGordon Guyatt
Aug 4, 2010·Annals of Internal Medicine·Amir QaseemUNKNOWN Clinical Guidelines Committee of the American College of Physicians
Jan 5, 2011·Journal of Clinical Epidemiology·Gordon GuyattHolger J Schünemann
Jan 7, 2011·Journal of Clinical Epidemiology·Howard BalshemGordon H Guyatt
Jan 15, 2013·Journal of Clinical Epidemiology·Jeff AndrewsHolger J Schünemann

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Citations

Sep 22, 2015·Journal of Clinical Epidemiology·Ani MovsisyanPaul Montgomery
Feb 2, 2016·Environment International·Rebecca L MorganHolger J Schünemann
Feb 26, 2016·Journal of the American Medical Informatics Association : JAMIA·Ronilda LacsonRamin Khorasani
Mar 8, 2016·Journal of Clinical Epidemiology·J André Knottnerus, Peter Tugwell
Aug 3, 2016·Journal of Clinical Monitoring and Computing·R N Holdefer, S A Skinner
Mar 8, 2017·AJR. American Journal of Roentgenology·Ronilda LacsonRamin Khorasani
Jun 18, 2017·Arthritis Care & Research·Susan M GoodmanJasvinder A Singh
Dec 2, 2017·Journal of Evaluation in Clinical Practice·Benjamin DjulbegovicWilliam Dale
Jul 14, 2018·Journal of Evaluation in Clinical Practice·Mathew Mercuri, Brian S Baigrie
Sep 12, 2018·Acta Anaesthesiologica Scandinavica·Carl Thomas AnthonMorten Hylander Møller
Aug 2, 2018·Journal of Evaluation in Clinical Practice·Mathew Mercuri, Amiram Gafni
Aug 7, 2020·Eating and Weight Disorders : EWD·Benedetta DemartiniGiovanni B Caputo
Jan 5, 2021·Journal of the American College of Emergency Physicians Open·Justin F RousseauRamin Khorasani
Mar 5, 2021·Journal of Clinical Epidemiology·Benjamin DjulbegovicGordon Guyatt

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