The “Child Health Evidence Week” and GRADE grid may aid transparency in the deliberative process of guideline development
Identifieur interne : 003D98 ( Main/Exploration ); précédent : 003D97; suivant : 003D99The “Child Health Evidence Week” and GRADE grid may aid transparency in the deliberative process of guideline development
Auteurs : Newton Opiyo [Kenya, Norvège] ; Sasha Shepperd [Royaume-Uni] ; Nyokabi Musila [Kenya] ; Mike English [Kenya, Royaume-Uni] ; Atle Fretheim [Norvège]Source :
- Journal of Clinical Epidemiology [ 0895-4356 ] ; 2012.
Abstract
To explore the evidence translation process during a 1-week national guideline development workshop (“Child Health Evidence Week”) in Kenya.
Nonparticipant observational study of the discussions of a multidisciplinary guideline development panel in Kenya. Discussions were aided by GRADE (Grading of Recommendations Assessment, Development, and Evaluation) grid.
Three key thematic categories emerged: 1) “referral to other evidence to support or refute the proposed recommendations;” 2) “assessment of the presented research evidence;” and 3) “assessment of the local applicability of evidence.” The types of evidence cited included research evidence and anecdotal evidence based on clinician experiences. Assessment of the research evidence revealed important challenges in the translation of evidence into recommendations, including absence of evidence, low quality or inconclusive evidence, inadequate reporting of key features of the management under consideration, and differences in panelists’ interpretation of the research literature. A broad range of factors with potential to affect local applicability of evidence were discussed.
The process of the “Child Health Evidence Week” combined with the GRADE grid may aid transparency in the deliberative process of guideline development, and provide a mechanism for comprehensive assessment, documentation, and reporting of multiple factors that influence the quality and applicability of guideline recommendations.
Url:
DOI: 10.1016/j.jclinepi.2012.03.004
PubMed: 22742914
PubMed Central: 3413881
Affiliations:
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Box 43640, Nairobi 00100, Kenya</nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>KEMRI-Wellcome Trust Research Programme, P.O. Box 43640, Nairobi 00100</wicri:regionArea><wicri:noRegion>Nairobi 00100</wicri:noRegion></affiliation></author><author><name sortKey="English, Mike" sort="English, Mike" uniqKey="English M" first="Mike" last="English">Mike English</name><affiliation wicri:level="1"><nlm:aff id="aff1">KEMRI-Wellcome Trust Research Programme, P.O. Box 43640, Nairobi 00100, Kenya</nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>KEMRI-Wellcome Trust Research Programme, P.O. 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Box 43640, Nairobi 00100, Kenya</nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>KEMRI-Wellcome Trust Research Programme, P.O. Box 43640, Nairobi 00100</wicri:regionArea><wicri:noRegion>Nairobi 00100</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:aff id="aff2">Section for International Health, Institute of Health and Society, University of Oslo, P.O. Box 1130, Blindern 0318, Oslo, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Section for International Health, Institute of Health and Society, University of Oslo, P.O. Box 1130, Blindern 0318, Oslo</wicri:regionArea><placeName><settlement type="city">Oslo</settlement><region nuts="2">Østlandet</region></placeName></affiliation></author><author><name sortKey="Shepperd, Sasha" sort="Shepperd, Sasha" uniqKey="Shepperd S" first="Sasha" last="Shepperd">Sasha Shepperd</name><affiliation wicri:level="4"><nlm:aff id="aff3">Department of Public Health, University of Oxford, Headington, OX37LF, Oxford, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Public Health, University of Oxford, Headington, OX37LF, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Musila, Nyokabi" sort="Musila, Nyokabi" uniqKey="Musila N" first="Nyokabi" last="Musila">Nyokabi Musila</name><affiliation wicri:level="1"><nlm:aff id="aff1">KEMRI-Wellcome Trust Research Programme, P.O. Box 43640, Nairobi 00100, Kenya</nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>KEMRI-Wellcome Trust Research Programme, P.O. Box 43640, Nairobi 00100</wicri:regionArea><wicri:noRegion>Nairobi 00100</wicri:noRegion></affiliation></author><author><name sortKey="English, Mike" sort="English, Mike" uniqKey="English M" first="Mike" last="English">Mike English</name><affiliation wicri:level="1"><nlm:aff id="aff1">KEMRI-Wellcome Trust Research Programme, P.O. Box 43640, Nairobi 00100, Kenya</nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>KEMRI-Wellcome Trust Research Programme, P.O. Box 43640, Nairobi 00100</wicri:regionArea><wicri:noRegion>Nairobi 00100</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="aff4">Department of Pediatrics, University of Oxford, John Radcliffe Hospital, Headington, Oxford, OX3 9DU, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Pediatrics, University of Oxford, John Radcliffe Hospital, Headington, Oxford, OX3 9DU</wicri:regionArea><orgName type="university">Université d'Oxford</orgName><placeName><settlement type="city">Oxford</settlement><region type="nation">Angleterre</region><region type="région" nuts="1">Oxfordshire</region></placeName></affiliation></author><author><name sortKey="Fretheim, Atle" sort="Fretheim, Atle" uniqKey="Fretheim A" first="Atle" last="Fretheim">Atle Fretheim</name><affiliation wicri:level="3"><nlm:aff id="aff2">Section for International Health, Institute of Health and Society, University of Oslo, P.O. Box 1130, Blindern 0318, Oslo, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Section for International Health, Institute of Health and Society, University of Oslo, P.O. Box 1130, Blindern 0318, Oslo</wicri:regionArea><placeName><settlement type="city">Oslo</settlement><region nuts="2">Østlandet</region></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="aff5">Global Health Unit, Norwegian Knowledge Centre for Health Services, P.O. Box 7004 St. Olavs plass, N-0130, Oslo, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Global Health Unit, Norwegian Knowledge Centre for Health Services, P.O. Box 7004 St. Olavs plass, N-0130, Oslo</wicri:regionArea><placeName><settlement type="city">Oslo</settlement><region nuts="2">Østlandet</region></placeName></affiliation></author></analytic><series><title level="j">Journal of Clinical Epidemiology</title><idno type="ISSN">0895-4356</idno><idno type="eISSN">1878-5921</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Objective</title><p>To explore the evidence translation process during a 1-week national guideline development workshop (“Child Health Evidence Week”) in Kenya.</p></sec><sec><title>Study Design and Setting</title><p>Nonparticipant observational study of the discussions of a multidisciplinary guideline development panel in Kenya. Discussions were aided by GRADE (Grading of Recommendations Assessment, Development, and Evaluation) grid.</p></sec><sec><title>Results</title><p>Three key thematic categories emerged: 1) “referral to other evidence to support or refute the proposed recommendations;” 2) “assessment of the presented research evidence;” and 3) “assessment of the local applicability of evidence.” The types of evidence cited included research evidence and anecdotal evidence based on clinician experiences. Assessment of the research evidence revealed important challenges in the translation of evidence into recommendations, including absence of evidence, low quality or inconclusive evidence, inadequate reporting of key features of the management under consideration, and differences in panelists’ interpretation of the research literature. A broad range of factors with potential to affect local applicability of evidence were discussed.</p></sec><sec><title>Conclusion</title><p>The process of the “Child Health Evidence Week” combined with the GRADE grid may aid transparency in the deliberative process of guideline development, and provide a mechanism for comprehensive assessment, documentation, and reporting of multiple factors that influence the quality and applicability of guideline recommendations.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Oxman, A D" uniqKey="Oxman A">A.D. Oxman</name></author><author><name sortKey="Lavis, J N" uniqKey="Lavis J">J.N. Lavis</name></author><author><name sortKey="Fretheim, A" uniqKey="Fretheim A">A. Fretheim</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Guyatt, G H" uniqKey="Guyatt G">G.H. Guyatt</name></author><author><name sortKey="Oxman, A D" uniqKey="Oxman A">A.D. 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Raine</name></author><author><name sortKey="Sanderson, C" uniqKey="Sanderson C">C. Sanderson</name></author><author><name sortKey="Hutchings, A" uniqKey="Hutchings A">A. Hutchings</name></author><author><name sortKey="Carter, S" uniqKey="Carter S">S. Carter</name></author><author><name sortKey="Larkin, K" uniqKey="Larkin K">K. Larkin</name></author><author><name sortKey="Black, N" uniqKey="Black N">N. Black</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Guyatt, G" uniqKey="Guyatt G">G. Guyatt</name></author><author><name sortKey="Akl, E A" uniqKey="Akl E">E.A. Akl</name></author><author><name sortKey="Hirsh, J" uniqKey="Hirsh J">J. Hirsh</name></author><author><name sortKey="Kearon, C" uniqKey="Kearon C">C. Kearon</name></author><author><name sortKey="Crowther, M" uniqKey="Crowther M">M. Crowther</name></author><author><name sortKey="Gutterman, D" uniqKey="Gutterman D">D. Gutterman</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Kenya</li><li>Norvège</li><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Oxfordshire</li><li>Østlandet</li></region><settlement><li>Oslo</li><li>Oxford</li></settlement><orgName><li>Université d'Oxford</li></orgName></list><tree><country name="Kenya"><noRegion><name sortKey="Opiyo, Newton" sort="Opiyo, Newton" uniqKey="Opiyo N" first="Newton" last="Opiyo">Newton Opiyo</name></noRegion><name sortKey="English, Mike" sort="English, Mike" uniqKey="English M" first="Mike" last="English">Mike English</name><name sortKey="Musila, Nyokabi" sort="Musila, Nyokabi" uniqKey="Musila N" first="Nyokabi" last="Musila">Nyokabi Musila</name></country><country name="Norvège"><region name="Østlandet"><name sortKey="Opiyo, Newton" sort="Opiyo, Newton" uniqKey="Opiyo N" first="Newton" last="Opiyo">Newton Opiyo</name></region><name sortKey="Fretheim, Atle" sort="Fretheim, Atle" uniqKey="Fretheim A" first="Atle" last="Fretheim">Atle Fretheim</name><name sortKey="Fretheim, Atle" sort="Fretheim, Atle" uniqKey="Fretheim A" first="Atle" last="Fretheim">Atle Fretheim</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Shepperd, Sasha" sort="Shepperd, Sasha" uniqKey="Shepperd S" first="Sasha" last="Shepperd">Sasha Shepperd</name></region><name sortKey="English, Mike" sort="English, Mike" uniqKey="English M" first="Mike" last="English">Mike English</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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