Visual transformation for guidelines presentation of the strength of recommendations and the certainty of evidence

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Authors

KLUGAR Miloslav KANTOROVÁ Lucia POKORNÁ Andrea LÍČENÍK Radim DUŠEK Ladislav SCHÜNEMANN Holger J . RIAD Abanoub KANTOR Jiří KLUGAROVÁ Jitka

Year of publication 2022
Type Article in Periodical
Magazine / Source Journal of Clinical Epidemiology
MU Faculty or unit

Faculty of Medicine

Citation
Web https://www.sciencedirect.com/science/article/pii/S0895435621003619?via%3Dihub#!
Doi http://dx.doi.org/10.1016/j.jclinepi.2021.11.009
Keywords GRADE; clinical practice guidelines; certainty of evidence; strength of recommendations; visual style; good practice statements
Description Objective The objective of this paper is to propose an approach to visual unification of adapted guidelines and transformation of classifications of certainty of evidence (CoE) and strength of recommendations (SoR) into the approach suggested by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group. Study design and Setting We carried out a literature search in MEDLINE and Epistemonikos, an analysis of selected guidelines, and an iterative discussion to decide on a consistent visual presentation and CoE and SoR depictions. Results The results of the literature search suggested this issue had not been addressed yet. The analysis of the chosen eight guidelines showed significant heterogeneity in the visual presentation of recommendations. Recommendations were often worded similarly to whether or not they were strong or conditional. Many guidelines contained "statements", almost all of which did not fulfill the good practice statement (GPS) criteria. We proposed an approach for transforming recommendations that are being adapted and which use various classification systems for CoE and SoR into GRADE and a consistent visual style. Conclusion Guideline developers should aim for unification in the formulation of recommendations to improve transferability.
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