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Marcos GRADE de la evidencia a la decisión (EtD): un enfoque sistemático y transparente para tomar decisiones sanitarias bien informadas. 2: Guías de práctica clínica

Overview of attention for article published in Gaceta Sanitaria, September 2017
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Title
Marcos GRADE de la evidencia a la decisión (EtD): un enfoque sistemático y transparente para tomar decisiones sanitarias bien informadas. 2: Guías de práctica clínica
Published in
Gaceta Sanitaria, September 2017
DOI 10.1016/j.gaceta.2017.03.008
Pubmed ID
Authors

Pablo Alonso-Coello, Andrew D. Oxman, Jenny Moberg, Romina Brignardello-Petersen, Elie A. Akl, Marina Davoli, Shaun Treweek, Reem A. Mustafa, Per O. Vandvik, Joerg Meerpohl, Gordon H. Guyatt, Holger J. Schünemann, el GRADE Working Group

Abstract

Clinicians do not have the time or resources to consider the underlying evidence for the myriad decisions they must make each day and, as a consequence, rely on recommendations from clinical practice guidelines. Guideline panels should consider all the relevant factors (criteria) that influence a decision or recommendation in a structured, explicit, and transparent way and provide clinicians with clear and actionable recommendations. In this article, we will describe the EtD frameworks for clinical practice recommendations. The general structure of the EtD framework for clinical recommendations is similar to EtD frameworks for other types of recommendations and decisions, and includes formulation of the question, an assessment of the different criteria, and conclusions. Clinical recommendations require considering criteria differently, depending on whether an individual patient or a population perspective is taken. For example, from an individual patient's perspective, out-of-pocket costs are an important consideration, whereas, from a population perspective, resource use (not only out-of-pocket costs) and cost effectiveness are important. From a population perspective, equity, acceptability, and feasibility are also important considerations, whereas the importance of these criteria is often limited from an individual patient perspective. Specific subgroups for which different recommendations may be required should be clearly identified and considered in relation to each criterion because judgments might vary across subgroups. This article is a translation of the original article published in the British Medical Journal. The EtD frameworks are currently used in the Clinical Practice Guideline Programme of the Spanish National Health System, co-ordinated by GuíaSalud.

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Geographical breakdown

Country Count As %
Unknown 39 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 7 18%
Student > Master 7 18%
Student > Bachelor 4 10%
Professor > Associate Professor 3 8%
Other 2 5%
Other 6 15%
Unknown 10 26%
Readers by discipline Count As %
Medicine and Dentistry 18 46%
Nursing and Health Professions 5 13%
Pharmacology, Toxicology and Pharmaceutical Science 2 5%
Computer Science 2 5%
Linguistics 1 3%
Other 2 5%
Unknown 9 23%