Users of clinical practice guidelines and other recommendations need to know how much confidence they can place in the recommendations. Systematic and explicit methods of making judgments can reduce errors and improve communication. We have developed a system for grading the quality of evidence and the strength of recommendations that can be applied across a wide range of interventions and contexts. In this article we present a summary of our approach from the perspective of a guideline user. Judgments about the strength of a recommendation require consideration of the balance between benefits and harms, the quality of the evidence, translation of the evidence into specific circumstances, and the certainty of the baseline risk. It is also important to consider costs (resource utilisation) before making a recommendation. Inconsistencies among systems for grading the quality of evidence and the strength of recommendations reduce their potential to facilitate critical appraisal and improve communication of these judgments. Our system for guiding these complex judgments balances the need for simplicity with the need for full and transparent consideration of all important issues.
%0 Journal Article
%1 Atkins:2004
%A Atkins, David
%A Best, Dana
%A Briss, Peter A
%A Eccles, Martin
%A Falck-Ytter, Yngve
%A Flottorp, Signe
%A Guyatt, Gordon H
%A Harbour, Robin T
%A Haugh, Margaret C
%A Henry, David
%A Hill, Suzanne
%A Jaeschke, Roman
%A Leng, Gillian
%A Liberati, Alessandro
%A Magrini, Nicola
%A Mason, James
%A Middleton, Philippa
%A Mrukowicz, Jacek
%A O'Connell, Dianne
%A Oxman, Andrew D
%A Phillips, Bob
%A Sch�nemann, Holger J
%A Edejer, Tessa Tan-Torres
%A Varonen, Helena
%A Vist, Gunn E
%A Williams, John W
%A Zaza, Stephanie
%A Group, G. R. A. D. E. Working
%D 2004
%J BMJ
%K Cost-Benefit_Analysis Evidence-Based_Medicine Humans Practice_Guidelines_as_Topic Quality_Assurance Health_Care EBM
%N 7454
%P 1490
%T Grading quality of evidence and strength of recommendations.
%U http://www.ncbi.nlm.nih.gov/pubmed/15205295
%V 328
%X Users of clinical practice guidelines and other recommendations need to know how much confidence they can place in the recommendations. Systematic and explicit methods of making judgments can reduce errors and improve communication. We have developed a system for grading the quality of evidence and the strength of recommendations that can be applied across a wide range of interventions and contexts. In this article we present a summary of our approach from the perspective of a guideline user. Judgments about the strength of a recommendation require consideration of the balance between benefits and harms, the quality of the evidence, translation of the evidence into specific circumstances, and the certainty of the baseline risk. It is also important to consider costs (resource utilisation) before making a recommendation. Inconsistencies among systems for grading the quality of evidence and the strength of recommendations reduce their potential to facilitate critical appraisal and improve communication of these judgments. Our system for guiding these complex judgments balances the need for simplicity with the need for full and transparent consideration of all important issues.
@article{Atkins:2004,
abstract = {Users of clinical practice guidelines and other recommendations need to know how much confidence they can place in the recommendations. Systematic and explicit methods of making judgments can reduce errors and improve communication. We have developed a system for grading the quality of evidence and the strength of recommendations that can be applied across a wide range of interventions and contexts. In this article we present a summary of our approach from the perspective of a guideline user. Judgments about the strength of a recommendation require consideration of the balance between benefits and harms, the quality of the evidence, translation of the evidence into specific circumstances, and the certainty of the baseline risk. It is also important to consider costs (resource utilisation) before making a recommendation. Inconsistencies among systems for grading the quality of evidence and the strength of recommendations reduce their potential to facilitate critical appraisal and improve communication of these judgments. Our system for guiding these complex judgments balances the need for simplicity with the need for full and transparent consideration of all important issues.},
added-at = {2009-11-05T17:25:34.000+0100},
author = {Atkins, David and Best, Dana and Briss, Peter A and Eccles, Martin and Falck-Ytter, Yngve and Flottorp, Signe and Guyatt, Gordon H and Harbour, Robin T and Haugh, Margaret C and Henry, David and Hill, Suzanne and Jaeschke, Roman and Leng, Gillian and Liberati, Alessandro and Magrini, Nicola and Mason, James and Middleton, Philippa and Mrukowicz, Jacek and O'Connell, Dianne and Oxman, Andrew D and Phillips, Bob and Sch�nemann, Holger J and Edejer, Tessa Tan-Torres and Varonen, Helena and Vist, Gunn E and Williams, John W and Zaza, Stephanie and Group, G. R. A. D. E. Working},
biburl = {https://www.bibsonomy.org/bibtex/299fb4f57a415b27dfaaf1f4bb71139a8/diego_ma},
interhash = {8c36355695fb243e9ecdd3cd73a550a1},
intrahash = {99fb4f57a415b27dfaaf1f4bb71139a8},
journal = {BMJ},
keywords = {Cost-Benefit_Analysis Evidence-Based_Medicine Humans Practice_Guidelines_as_Topic Quality_Assurance Health_Care EBM},
month = Jun,
number = 7454,
pages = 1490,
timestamp = {2009-11-05T17:25:34.000+0100},
title = {Grading quality of evidence and strength of recommendations.},
url = {http://www.ncbi.nlm.nih.gov/pubmed/15205295},
volume = 328,
year = 2004
}