Article type
Year
Abstract
Background:
When developing systematic reviews (SR) and clinical practice guidelines (CG), consideration of patients’ values and preferences (VPs) is an important issue. GRADE (Grading of Recommendations Assessment, Development and Evaluation) considers the quality of the evidence supporting estimates of VPs and their variability when moving from evidence to recommendations. Nevertheless, detailed guidance about how to evaluate quality of evidence of studies on VPs is unavailable.
Objectives:
To develop a framework to rate the quality of the evidence about VPs information.
Methods:
Iterative process including: brainstorming of international groups of methodologists and feedback from the GRADE Working Group; systematic review of methodological guidelines handbooks; and review of the methodological literature in the field of guideline development and health economics.
Results:
We have developed an initial proposal to rate the quality of evidence from primary studies addressing patients’ typical VPs. For the risk of bias we propose to consider several aspects common across study designs (e.g. selection bias) and some specific to the type of methodology used (e.g. for standard gamble, qualitative research). The framework considers other factors including consistency, precision, directness and publication bias. Starting from high quality, limitations in these aspects lowers confidence in the VPs results. We will present the full framework with examples and a presentation of the results in a summary of findings table.
Conclusions:
There is an urgent need for a framework to evaluate the confidence we can place in bodies of evidence addressing typical VPs. Our framework could help the guideline community to bring more rigour into the consideration of VPs when developing recommendations.
When developing systematic reviews (SR) and clinical practice guidelines (CG), consideration of patients’ values and preferences (VPs) is an important issue. GRADE (Grading of Recommendations Assessment, Development and Evaluation) considers the quality of the evidence supporting estimates of VPs and their variability when moving from evidence to recommendations. Nevertheless, detailed guidance about how to evaluate quality of evidence of studies on VPs is unavailable.
Objectives:
To develop a framework to rate the quality of the evidence about VPs information.
Methods:
Iterative process including: brainstorming of international groups of methodologists and feedback from the GRADE Working Group; systematic review of methodological guidelines handbooks; and review of the methodological literature in the field of guideline development and health economics.
Results:
We have developed an initial proposal to rate the quality of evidence from primary studies addressing patients’ typical VPs. For the risk of bias we propose to consider several aspects common across study designs (e.g. selection bias) and some specific to the type of methodology used (e.g. for standard gamble, qualitative research). The framework considers other factors including consistency, precision, directness and publication bias. Starting from high quality, limitations in these aspects lowers confidence in the VPs results. We will present the full framework with examples and a presentation of the results in a summary of findings table.
Conclusions:
There is an urgent need for a framework to evaluate the confidence we can place in bodies of evidence addressing typical VPs. Our framework could help the guideline community to bring more rigour into the consideration of VPs when developing recommendations.