Tejan Baldeh1,2, Zuleika Saz-Parkinson3, Paola Muti1,4, Nancy Santesso1,2,5, Gian Paolo Morgano1,2, Wojtek Wiercioch1,2, Robby Nieuwlaat1,2, Axel Gräwingholt6,7, Mireille Broeders6,8,9, Stephen Duffy6,10, Solveig Hofvind6,11,12, Lennarth Nystrom6,13, Lydia Ioannidou-Mouzaka6,14, Sue Warman6, Helen McGarrigle6,15, Susan Knox6,16, Patricia Fitzpatrick6,17, Paolo Giorgi Rossi6,18, Cecily Quinn6,19, Bettina Borisch6,20, Annette Lebeau6,21,22, Chris de Wolf6, Miranda Langendam5,6,23, Thomas Piggott1, Livia Giordano6,24, Cary van Landsveld-Verhoeven6,9, Jacques Bernier6, Peter Rabe6, Holger J Schünemann25,26,27,28,29. 1. Department of Health Research Methodology, Evidence and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, 1280 Main Street West, Hamilton, ON, L8N 4K1, Canada. 2. Michael G. DeGroote Cochrane Canada and MacGRADE Centres, 1280 Main Street West, Hamilton, Ontario, L8S 4K1, Canada. 3. European Commission, Joint Research Centre (JRC), Via E. Fermi 2749 - TP 127, I-21027, Ispra, VA, Italy. 4. Department of Oncology, McMaster University, Hamilton, Canada. 5. Cochrane GRADEing Methods Group, 1280 Main Street West, Hamilton, Ontario, L8S 4K1, Canada. 6. European Commission Initiative on Breast Cancer Guidelines Development Group, European Commission, JRC, Ispra, Italy. 7. Private Group Practice for Radiology, Radiologie am Theater, Paderborn, Germany. 8. Department for Health Evidence, Radboud University Medical Center, PO Box 9101, 6525 EZ, HB, Nijmegen, The Netherlands. 9. Dutch Expert Centre for Screening, PO Box 6873, 6503, GJ, Nijmegen, the Netherlands. 10. Centre for Cancer Prevention, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, United Kingdom. 11. Cancer Registry of Norway, PO 5313, Majorstua, 0304, Oslo, Norway. 12. Oslo Metropolitan University, Pilestredet 48, 0167, Oslo, Norway. 13. Umeå University, 90187, Umeå, Sweden. 14. Leto Gynecological-Surgical and Obstetrical Clinic, 18, Avenue Kifissias, 11526, Athens, Greece. 15. Cardiff and Vale Breast Centre, University Hospital Llandough, Llandough, United Kingdom. 16. EUROPA DONNA - The European Breast Cancer Coalition, Piazza Amendola 3, 20149, Milan, Italy. 17. National Screening Service, Kings Inns House, 200 Parnell Street, Dublin, D01 A3Y8, Ireland. 18. Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy. 19. School of Medicine, University College Dublin, BreastCheck, Irish National Breast Screening Programme, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland. 20. Insitute of Global Health, University of Geneva, chemin des Mines 9, 1202, Geneva, Switzerland. 21. Department of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 22. University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany. 23. Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands. 24. CPO Piedmont-AOU Citta della Salute e della Scienza, via Cavour 31, 10131, Turin, Italy. 25. Department of Health Research Methodology, Evidence and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, 1280 Main Street West, Hamilton, ON, L8N 4K1, Canada. schuneh@mcmaster.ca. 26. Michael G. DeGroote Cochrane Canada and MacGRADE Centres, 1280 Main Street West, Hamilton, Ontario, L8S 4K1, Canada. schuneh@mcmaster.ca. 27. Cochrane GRADEing Methods Group, 1280 Main Street West, Hamilton, Ontario, L8S 4K1, Canada. schuneh@mcmaster.ca. 28. European Commission Initiative on Breast Cancer Guidelines Development Group, European Commission, JRC, Ispra, Italy. schuneh@mcmaster.ca. 29. Department of Medicine, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4K1, Canada. schuneh@mcmaster.ca.
Abstract
BACKGROUND: During healthcare guideline development, panel members often have implicit, different definitions of health outcomes that can lead to misunderstandings about how important these outcomes are and how to balance benefits and harms. McMaster GRADE Centre researchers developed 'health outcome descriptors' for standardizing descriptions of health outcomes and overcoming these problems to support the European Commission Initiative on Breast Cancer (ECIBC) Guideline Development Group (GDG). We aimed to determine which aspects of the development, content, and use of health outcome descriptors were valuable to guideline developers. METHODS: We developed 24 health outcome descriptors related to breast cancer screening and diagnosis for the European Commission Breast Guideline Development Group (GDG). Eighteen GDG members provided feedback in written format or in interviews. We then evaluated the process and conducted two health utility rating surveys. RESULTS: Feedback from GDG members revealed that health outcome descriptors are probably useful for developing recommendations and improving transparency of guideline methods. Time commitment, methodology training, and need for multidisciplinary expertise throughout development were considered important determinants of the process. Comparison of the two health utility surveys showed a decrease in standard deviation in the second survey across 21 (88%) of the outcomes. CONCLUSIONS: Health outcome descriptors are feasible and should be developed prior to the outcome prioritization step in the guideline development process. Guideline developers should involve a subgroup of multidisciplinary experts in all stages of development and ensure all guideline panel members are trained in guideline methodology that includes understanding the importance of defining and understanding the outcomes of interest.
BACKGROUND: During healthcare guideline development, panel members often have implicit, different definitions of health outcomes that can lead to misunderstandings about how important these outcomes are and how to balance benefits and harms. McMaster GRADE Centre researchers developed 'health outcome descriptors' for standardizing descriptions of health outcomes and overcoming these problems to support the European Commission Initiative on Breast Cancer (ECIBC) Guideline Development Group (GDG). We aimed to determine which aspects of the development, content, and use of health outcome descriptors were valuable to guideline developers. METHODS: We developed 24 health outcome descriptors related to breast cancer screening and diagnosis for the European Commission Breast Guideline Development Group (GDG). Eighteen GDG members provided feedback in written format or in interviews. We then evaluated the process and conducted two health utility rating surveys. RESULTS: Feedback from GDG members revealed that health outcome descriptors are probably useful for developing recommendations and improving transparency of guideline methods. Time commitment, methodology training, and need for multidisciplinary expertise throughout development were considered important determinants of the process. Comparison of the two health utility surveys showed a decrease in standard deviation in the second survey across 21 (88%) of the outcomes. CONCLUSIONS: Health outcome descriptors are feasible and should be developed prior to the outcome prioritization step in the guideline development process. Guideline developers should involve a subgroup of multidisciplinary experts in all stages of development and ensure all guideline panel members are trained in guideline methodology that includes understanding the importance of defining and understanding the outcomes of interest.
Entities:
Keywords:
Guideline methodology; Health outcomes; Health states; Health utility
Authors: Ariel Izcovich; Adam Cuker; Robert Kunkle; Ignacio Neumann; Julie Panepinto; Menaka Pai; Matthew Seftel; Matthew C Cheung; Richard Lottenberg; Michael Byrne; Robert Plovnick; Deirdra Terrell; Jennifer L Holter-Chakrabarty; Benjamin Djulbegovic; Lisa K Hicks; Wojtek Wiercioch; Robby Nieuwlaat; Holger J Schünemann Journal: Blood Adv Date: 2020-05-12
Authors: Gian Paolo Morgano; Lawrence Mbuagbaw; Nancy Santesso; Feng Xie; Jan L Brozek; Uwe Siebert; Antonio Bognanni; Wojtek Wiercioch; Thomas Piggott; Andrea J Darzi; Elie A Akl; Ilse M Verstijnen; Elena Parmelli; Zuleika Saz-Parkinson; Pablo Alonso-Coello; Holger J Schünemann Journal: BMJ Open Date: 2022-03-10 Impact factor: 2.692