CLINICAL GUIDELINES USING THE GRADE SYSTEM (GRADING OF RECOMMENDATIONS, ASSESSMENT, DEVELOPMENT AND EVALUATION)
Cómo interpretar guías de práctica clínica elaboradas con metodología GRADE
Author
Mendoza, Carolina; División de Prevención y Control de Enfermedades, Subsecretaría Salud Pública, Ministerio de Salud de Chile
Kraemer, Patricia; Subsecretaría Salud Pública, Ministerio de Salud de Chile
Herrera, Paloma; Subsecretaría Salud Pública, Ministerio de Salud de Chile
Burdiles, Pamela; Subsecretaría Salud Pública, Ministerio de Salud de Chile
Sepúlveda, Dino; Subsecretaría Salud Pública, Ministerio de Salud de Chile; Programa de Salud Global de la Escuela de Salud Pública, Universidad de Chile
Núñez, Eliozka; Ministerio de Salud de Chile
Muñoz, Cecilia; Subsecretaría de Salud Pública, Ministerio de Salud de Chile
Neumann, Ignacio; Pontificia Universidad Católica de Chile; Hospital Dr. Sótero del Río
Abstract
The Ministry of Health of Chile, aiming to improve the quality of clinical practice guidelines, gradually incorporated the GRADE system (Grading of Recommendations, Assessment, Development and Evaluation) to develop evidence based recommendations. This system summarizes and evaluates the certainty of the available evidence. It moves from evidence to decision in a systematic and transparent manner, based on four main dimensions: balance between benefits and harms, certainty of evidence, patient’s values and preferences and use of resources. The GRADE system produces strong and conditional recommendations. Strong recommendations provide confidence that the favorable consequences of an intervention clearly outweigh the adverse consequences, or vice versa. These recommendations apply to a broad range of patients and circumstances. Conditional recommendations, however, indicate that there is a close balance between favorable and unfavorable consequences of the intervention, there is uncertainty in the magnitude of benefits or adverse effects, there is uncertainty or variability in values and preferences of individuals or costs are not justified. These recommendations apply to many patients, but not all of them: ideally they should be discussed with each person. To achieve a better implementation of the recommendations made with GRADE methodology, health professionals should know the meaning of strong and conditional recommendations and they should be able to critically assess of them. The Ministry of Health of Chile, aiming to improve the quality of clinical practice guidelines, gradually incorporated the GRADE system (Grading of Recommendations, Assessment, Development and Evaluation) to develop evidence based recommendations. This system summarizes and evaluates the certainty of the available evidence. It moves from evidence to decision in a systematic and transparent manner, based on four main dimensions: balance between benefits and harms, certainty of evidence, patient’s values and preferences and use of resources. The GRADE system produces strong and conditional recommendations. Strong recommendations provide confidence that the favorable consequences of an intervention clearly outweigh the adverse consequences, or vice versa. These recommendations apply to a broad range of patients and circumstances. Conditional recommendations, however, indicate that there is a close balance between favorable and unfavorable consequences of the intervention, there is uncertainty in the magnitude of benefits or adverse effects, there is uncertainty or variability in values and preferences of individuals or costs are not justified. These recommendations apply to many patients, but not all of them: ideally they should be discussed with each person. To achieve a better implementation of the recommendations made with GRADE methodology, health professionals should know the meaning of strong and conditional recommendations and they should be able to critically assess of them.
Metadata
Show full item recordRelated items
Showing items related by title, author, creator and subject.
-
Vigilancia epidemiológica de sífilis (A50 - A53) y gonorrea (A54) Ministerio de Salud, Subsecretaría de Salud Pública, División de Planificación Sanitaria, Departamento de Epidemiología, Santiago, Chile
Herrera Carazo,Patricio. Revista chilena de obstetricia y ginecología v.78 n.5 2013 -
ANÁLISIS, DIAGNÓSTICO Y PROPUESTA DE MEJORA DEL “PROGRAMA 24 HORAS” DE LA SUBSECRETARÍA DE PREVENCIÓN DEL DELITO DE CHILE, DESDE UNA PERSPECTIVA DE POLÍTICA PÚBLICA DE PREVENCIÓN DEL DELITO
Zamorano Mancini, Francisca. Estado, Gobierno y Gestión Pública; Núm. 32 (2018): GESTIÓN PÚBLICA DE LAS POLÍTICAS DE SEGURIDAD CIUDADANA; pp. 187–264 -
Analysis, diagnosis and proposal for improving the “24 hours program” of Chile’s crime prevention undersecretary, from a crime prevention public policy perspective
Zamorano Mancini, Francisca. Estado, Gobierno y Gestión Pública; Vol. 16 No. 32 (2018): Gestión pública de las políticas de seguridad ciudadana; pp. 187–264