Colby Dixon1, Paul E Dixon2, Shahnaz Sultan3, Reem Mustafa4, Rebecca L Morgan5, Mohammed Hassan Murad6, Yngve Falck-Ytter7, Philipp Dahm8. 1. Urology Section, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA; Department of Urology, University of Minnesota, Minneapolis, MN, USA. 2. St. John's Hospital, St. Paul, MN, USA. 3. Gastroenterology Section, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA; Department of Medicine, University of Minnesota, Minneapolis, MN, USA. 4. Division of Nephrology and Hypertension, Department of Internal Medicine, University of Kansas, Kansas City, KA, USA. 5. Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada. 6. Mayo Clinic, Evidence Based Practice Center, Rochester, MN, USA. 7. Division of Gastroenterology and Liver Disease, Case Western Reserve University, Cleveland, OH, USA. 8. Urology Section, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA; Department of Urology, University of Minnesota, Minneapolis, MN, USA. Electronic address: pdahm@umn.edu.
Abstract
OBJECTIVES: We assessed whether guidelines published by organizations based in the United States comply with published criteria for the use of the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. STUDY DESIGN AND SETTING: We performed a cross-sectional study of all clinical practice guidelines that indicated the use of the GRADE approach, were published between 2011 and 2018, and listed in the National Guidelines Clearinghouse. RESULTS: We included 67 guideline documents from 44 of 135 (32.6%) US-based organizations that indicated the use of the GRADE approach. The majority (60/67, 89.6%) of guidelines defined the certainty of evidence consistent with GRADE, but only approximately 1 in 10 (7/67, 10.4%) explicitly reported consideration of all eight criteria to assess the certainty in the evidence for rating down and up. A majority of guidelines (36/67, 53.7%) provided a summary of the evidence, described explicit consideration of all four central domains (36/67, 53.7%), and rated the strength of recommendation consistent with GRADE (36/67, 53.7%). CONCLUSION: Approximately one in three US-based organizations developing evidence-based guidelines report the use of GRADE, but adherence to published criteria is inconsistent. As uptake of the GRADE approach increases in the United States, continued efforts to train guideline methodologists and panel members are important.
OBJECTIVES: We assessed whether guidelines published by organizations based in the United States comply with published criteria for the use of the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. STUDY DESIGN AND SETTING: We performed a cross-sectional study of all clinical practice guidelines that indicated the use of the GRADE approach, were published between 2011 and 2018, and listed in the National Guidelines Clearinghouse. RESULTS: We included 67 guideline documents from 44 of 135 (32.6%) US-based organizations that indicated the use of the GRADE approach. The majority (60/67, 89.6%) of guidelines defined the certainty of evidence consistent with GRADE, but only approximately 1 in 10 (7/67, 10.4%) explicitly reported consideration of all eight criteria to assess the certainty in the evidence for rating down and up. A majority of guidelines (36/67, 53.7%) provided a summary of the evidence, described explicit consideration of all four central domains (36/67, 53.7%), and rated the strength of recommendation consistent with GRADE (36/67, 53.7%). CONCLUSION: Approximately one in three US-based organizations developing evidence-based guidelines report the use of GRADE, but adherence to published criteria is inconsistent. As uptake of the GRADE approach increases in the United States, continued efforts to train guideline methodologists and panel members are important.
Authors: Shahnaz Sultan; Madelin R Siedler; Rebecca L Morgan; Toju Ogunremi; Philipp Dahm; Lisa A Fatheree; Thomas S D Getchius; Pamela K Ginex; Priya Jakhmola; Emma McFarlane; M Hassan Murad; Robyn L Temple Smolkin; Yasser S Amer; Murad Alam; Bianca Y Kang; Yngve Falck-Ytter; Reem A Mustafa Journal: J Gen Intern Med Date: 2021-09-20 Impact factor: 6.473