Using Explicit Thresholds were valuable for judging Benefits and Harms in partially contextualized GRADE Guidelines.
J Clin Epidemiol
; 147: 69-75, 2022 07.
Article
em En
| MEDLINE
| ID: mdl-35364230
ABSTRACT
OBJECTIVES:
Guideline panels must assess the magnitude of health benefits and harms to develop sensible recommendations. However, they rarely use explicit thresholds. In this paper we report on the piloting and the use thresholds for benefits and harms. STUDY DESIGN ANDSETTING:
We piloted the use of thresholds in a Chilean COVID-19 living guideline. For each of the critical outcomes, we asked panelists to suggest values of the thresholds for large, moderate, small, or trivial or no effect. We collected this information through a survey and an on-line discussion.RESULTS:
Twelve panelists decided on thresholds for three critical outcomes (mortality, need for mechanical ventilation and serious adverse events). For all outcomes, an absolute risk reduction was considered larger with more than 50 events, moderate with less than 50 events, small with less than 25 events, and trivial with less than 10 events. Having these a priori thresholds in place significantly impacted on the development of recommendations.CONCLUSION:
Explicit thresholds were a valuable addition to the judgment of the certainty in the evidence, to decide the direction and strength of the recommendation and to evaluate the need for update. We believe this is a line of research worth perusing.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
COVID-19
Tipo de estudo:
Guideline
/
Qualitative_research
Limite:
Humans
País como assunto:
America do sul
/
Chile
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article