Applying GRADE to prognostic evidence

Article type
Year
Authors
Iorio A1, Williams K2, Guyatt G3, Schunemann H3, Hayden J4
1McMaster University
2Child Health Field, Prognosis Methods Group and Developmental Psychosocial and Learning Difficulties Review Group
3McMaster University, Canada
4Dalhousie University, Canada
Abstract
Objective: To learn all aspects of applying GRADE (Grading of Recommendations, Assessment, Development and Evaluations) to a body of prognostic evidence, which often requires the appraisal of observational non-comparative studies.

Description: Observational studies addressing patients' prognosis may provide robust estimates of the likelihood of undesirable or desirable outcomes in both treated and untreated patients. Knowledge of the risk of adverse outcomes or the likelihood of spontaneous resolution of symptoms is critical in predicting the likely impact of treatment and planning diagnostic investigations. In two recent articles we examined factors that affect confidence in estimates of prognosis (Iorio A. BMJ 2015;350:e870, and Spencer F. BMJ 2012;345:e7401), providing some examples of how this might also influence the confidence in estimates of absolute treatment effect.

Participants will compile a prognostic evidence profile on an exemplary prognostic review. After completing the workshop, participants will:
1. know the principles of the GRADE approach to prognosis;
2. be able to prepare a 'Summary of findings' table for a prognostic question;
3. be able to assign levels of evidence to a body of prognostic evidence according to GRADE (evidence profile);
4. be able to assign an overall level of confidence in a body of prognostic evidence by applying a GRADE framework;
5. explore the role of prognostic evidence in the process leading from evidence to decision.