Title
A case for clarity, consistency, and helpfulness: State-of-the-art clinical practice guidelines in endocrinology using the grading of recommendations, assessment, development, and evaluation system
Date Issued
01 January 2008
Access level
open access
Resource Type
review
Author(s)
Swiglo B.A.
Murad M.H.
Schünemann H.J.
Kunz R.
Vigersky R.A.
Guyatt G.H.
Mayo Clinic
Publisher(s)
Endocrine Society
Abstract
Context: The Endocrine Society, and a growing number of other organizations, have adopted the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to develop clinical practice guidelines and grade the strength of recommendations and the quality of the evidence. Despite the use of GRADE in several of The Endocrine Society's clinical practice guidelines, endocrinologists have not had access to a context-specific discussion of this system and its merits. Evidence Acquisition: The authors are involved in the development of the GRADE standard and its application to The Endocrine Society clinical practice guidelines. Examples were extracted from these guidelines to illustrate how this grading system enhances the quality of practice guidelines. Evidence Synthesis: We summarized and described the components of the GRADE system, and discussed the features of GRADE that help bring clarity and consistency to guideline documents, making them more helpful to practicing clinicians and their patients with endocrine disorders. Conclusions: GRADE describes the quality of the evidence using four levels: very low, low, moderate, and high quality. Recommendations can be either strong ("we recommend") or weak ("we suggest"), and this strength reflects the confidence that guideline panel members have that patients who receive recommended care will be better off. The separation of the quality of the evidence from the strength of the recommendation recognizes the role that values and preferences, as well as clinical and social circumstances, play in formulating practice recommendations. Copyright © 2008 by The Endocrine Society.
Start page
666
End page
673
Volume
93
Issue
3
Language
English
OCDE Knowledge area
Endocrinología, Metabolismo (incluyendo diabetes, hormonas)
Ciencias del cuidado de la salud y servicios (administración de hospitales, financiamiento)
Scopus EID
2-s2.0-40849142097
PubMed ID
Source
Journal of Clinical Endocrinology and Metabolism
ISSN of the container
0021972X
DOI of the container
10.1210/jc.2007-1907
Source funding
Endocrine Society
European Commission
FP7 People: Marie-Curie Actions
Sponsor(s)
Disclosure Statement: V.M.M. receives funding from The Endocrine Society to conduct systematic reviews and metaanalyses in support of clinical practice guidelines. R.A.V. chairs the Clinical Guidelines Subcommittee of The Endocrine Society. H.J.S., R.K., G.H.G., and V.M.M. are members of the Grading of Recommendations, Assessment, Development, and Evaluation Working Group. H.J.S. is funded by a European Commission Grant (The human factor, mobility and Marie Curie Actions. Scientist Reintegration Grant IGR 42192-“GRADE”). Otherwise, the authors have nothing to disclose.
Sources of information:
Directorio de Producción Científica
Scopus