SlideServe
Télécharger Obtenir Pro
Menu
Accueil Pro
Préférences
ApparenceLight Aide et commentaires
© SlideServe · v2026

Implementing GRADE

said avatar
said
6 diapositives · 209 Views · Aug 08, 2012

Implementation of GRADE methodology at Tufts Center for Kidney Disease, highlighting guidelines development since 2000 and GRADE adoption since 2007. Key aspects include the structure of the Evidence Review Team, which comprises full-time guideline methodologists and international experts, and the comprehensive, standardized approach employed in evidence evaluation. Advantages like improved evidence consistency and clearer recommendations are discussed, alongside challenges such as increased workloads and complexity in Evidence Profile creation. Ultimately, feedback from the workgroup indicates a preference for the structured GRADE system despite potential drawbacks.

#kidney disease guidelines #grade methodology #evidence review #systematic reviews #guideline development #tufts medical center #decisionmaking #clinical outcomes
Implementing GRADE - slide 1
01 / 6Implementing GRADE
1 / 17

Télécharger la présentation

Implementing GRADE
Une image / un lien ci-dessous est fourni (tel quel) pour télécharger la présentation

Politique de téléchargement : le contenu du site vous est fourni TEL QUEL pour votre information et votre usage personnel ; il ne peut être vendu, concédé sous licence ni partagé sur d’autres sites sans l’accord de son auteur.Le contenu vous est fourni TEL QUEL, pour votre information et votre usage personnel uniquement. Téléchargez la présentation en cliquant sur ce lien. Lors du téléchargement, si vous ne parvenez pas à télécharger une présentation, l’éditeur a peut-être supprimé le fichier de son serveur.Pendant le téléchargement, si vous ne parvenez pas à obtenir une présentation, le fichier a peut-être été supprimé par l’éditeur.

F I N

Plus de contenu associé

Transcription de la présentation

    1. 1 Implementing GRADE Experience of the Tufts Center for Kidney Disease Guideline Development and Implementation Tufts Medical Center, Boston MA Guideline methodology since 2000 (18 GL) Implementing GRADE since 2007 (6 GL) Ethan Balk, MD MPH Associate Director

    2. 2 Evidence Review Team for KDOQI & KDIGO Kidney guidelines Full-time guideline & systematic review methodologists ~6 FTE MDs, guideline fellows, research associates (MPH-level) Work Group of ~15-20 international domain experts 18 month process; 3 meetings Tufts Center for Kidney Disease Guideline Development and Implementation

    3. 3 Advantages compared to previous systems Formal approach, standardized steps & tables Gets Work Group to consider may aspects of evidence as they pertain to guidelines Overall evidence quality, consistency, applicability Rank outcomes (clinically important outcomes) Balance benefits and harms Simpler descriptions of recommendation levels (1, 2) and evidence quality (A, B, C, D) Less arbitrary, more consistent connection between level of recommendations and quality of evidence Eliminates reinventing the wheel

    4. 4 Disadvantages compared to previous Increased organizational workload ? # summary tables for specific outcomes Evidence Profile creation resource intensive Training Work Group in GRADE methods, Evidence Profiles complicated Increases # of arbitrary formal decisions to maintain consistency Study quality: (A/B/C) ? Methodological quality (0, -1, -2) 2A + 4B + 1C = -1? 2B + 2C = -1? -2? Translating consistency ? (0, -1, -2) Translating directness ? (0, -1, -2)

    5. 5 Responses to use of GRADE Work Group likes because it sets a standard structure and seems less arbitrary simplifies decisionmaking about strength and content of recommendation focuses on clinically important outcomes But, large # of steps = ? resources, time Difficult for domain experts Some frustration about highly detailed work of filling every cell of Evidence Profile Added work load may diminish participation