Article type
Abstract
Background: Overlapping systematic reviews (SRs) are increasingly frequent in the medical literature. They can easily originate discordant evidence. Reconciling conflicting evidence is a dimension not sufficiently addressed by guideline-development tools. As part of a wider research project supported by the Italian Ministry of Health, we are carrying out a survey to learn more about discordant SRs and their impact on the development of clinical recommendations (CRs).
Objectives: To identify key dimensions and informational needs that could be useful in dealing with discordant evidence in the context of the guideline decision-making process.
Methods: The survey consists of two parts. In the first one general information about the respondents is collected (ie. age, role, expertise, etc…). In the second one we present 4 GRADE Summary of Findings (SoF) tables summarising the results of 4 overlapping discordant SRs and 10 questions investigating the use of the evidence presented to take a decision about a possible CR. Moving from a real scenario, we explore the information needs when dealing with potential discordant evidence.
Results: The survey was sent to 80 people involved at different levels in the development of CRs. To date it has been completed by the 40% of the contacted people. First results show that the most-wanted information when in the presence of overlapping SRs are (multiple choice possible): Risk of Bias of SRs (69,2%); consistency between studies' results (65,4%); included studies in each SR (61,5%); and, methodological limitations in primary studies (50%).
Any response rate above 50% would be considered sufficient for a descriptive study. We will send a maximum of 3 reminders in a 2-month period.
Conclusions: The answers to the survey will help in identifying key dimensions and information needed when in presence of overlapping, discordant SRs. This will be used to develop a new module (Discordant Module) of the GRADE Working Group Guideline Development Tool (GDT - http://gdt.guidelinedevelopment.org) designed to support guideline developers in dealing with overlapping and discordant evidence.
Objectives: To identify key dimensions and informational needs that could be useful in dealing with discordant evidence in the context of the guideline decision-making process.
Methods: The survey consists of two parts. In the first one general information about the respondents is collected (ie. age, role, expertise, etc…). In the second one we present 4 GRADE Summary of Findings (SoF) tables summarising the results of 4 overlapping discordant SRs and 10 questions investigating the use of the evidence presented to take a decision about a possible CR. Moving from a real scenario, we explore the information needs when dealing with potential discordant evidence.
Results: The survey was sent to 80 people involved at different levels in the development of CRs. To date it has been completed by the 40% of the contacted people. First results show that the most-wanted information when in the presence of overlapping SRs are (multiple choice possible): Risk of Bias of SRs (69,2%); consistency between studies' results (65,4%); included studies in each SR (61,5%); and, methodological limitations in primary studies (50%).
Any response rate above 50% would be considered sufficient for a descriptive study. We will send a maximum of 3 reminders in a 2-month period.
Conclusions: The answers to the survey will help in identifying key dimensions and information needed when in presence of overlapping, discordant SRs. This will be used to develop a new module (Discordant Module) of the GRADE Working Group Guideline Development Tool (GDT - http://gdt.guidelinedevelopment.org) designed to support guideline developers in dealing with overlapping and discordant evidence.