Article type
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Abstract
Background: Development of a health care guideline is a complex process. Using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group approach to grading, recommendations can be tailored to individual values and preferences through shared decision making.
Objectives: To update previous recommendations developed by the working group on dysphagia and stroke from the Department of Rehabilitation in Kaohsiung Chang Gung Memorial Hospital for the evaluation of the accuracy of the water-swallow test for dysphagia in people with stroke.
Methods: Members of the working group on dysphagia and stroke from the Department of Rehabilitation in Kaohsiung Chang Gung Memorial Hospital. Recommendations were formulated according to the GRADE system to describe both the strength of recommendations and the quality of evidence. The recommendations were discussed and approved by all members of the Working Group. The association between GRADE factors and strength of recommendations was assessed using logistic regression and multilevel mixed-effect logistic regression models. Agreement is high for a strong recommendation when confidence is high, and agreement is high for a weak recommendation when confidence is low.
Results: Eight members of the panel participated in the deliberation on recommendations and completed the questionnaire. The predictive model suggested an approximately 90% probability of a strong recommendation when confidence in the effects of intervention was high.
Conclusions: This update summarizes the new data regarding the (GRADE) evaluation of the diagnostic accuracy of the water-swallow test for dysphagia for people with stroke; it played an important role in screening tests, water-swallow tests with a volume of 50 ml or more have higher accuracy. Our findings have potentially important policy implications for measurements of the quality of care.
Objectives: To update previous recommendations developed by the working group on dysphagia and stroke from the Department of Rehabilitation in Kaohsiung Chang Gung Memorial Hospital for the evaluation of the accuracy of the water-swallow test for dysphagia in people with stroke.
Methods: Members of the working group on dysphagia and stroke from the Department of Rehabilitation in Kaohsiung Chang Gung Memorial Hospital. Recommendations were formulated according to the GRADE system to describe both the strength of recommendations and the quality of evidence. The recommendations were discussed and approved by all members of the Working Group. The association between GRADE factors and strength of recommendations was assessed using logistic regression and multilevel mixed-effect logistic regression models. Agreement is high for a strong recommendation when confidence is high, and agreement is high for a weak recommendation when confidence is low.
Results: Eight members of the panel participated in the deliberation on recommendations and completed the questionnaire. The predictive model suggested an approximately 90% probability of a strong recommendation when confidence in the effects of intervention was high.
Conclusions: This update summarizes the new data regarding the (GRADE) evaluation of the diagnostic accuracy of the water-swallow test for dysphagia for people with stroke; it played an important role in screening tests, water-swallow tests with a volume of 50 ml or more have higher accuracy. Our findings have potentially important policy implications for measurements of the quality of care.