GRADE pearls and pitfalls—Part 2: Clinical practice guidelines

Author:

Granholm Anders12ORCID,Al Duhailib Zainab234ORCID,Alhazzani Waleed25678,Oczkowski Simon256,Belley‐Cote Emilie259,Møller Morten Hylander12ORCID

Affiliation:

1. Department of Intensive Care Copenhagen University Hospital – Rigshospitalet Copenhagen Denmark

2. Guidelines in Intensive Care Medicine, Development and Evaluation (GUIDE) Group Hamilton Ontario Canada

3. Critical Care Medicine Department King Faisal Specialist Hospital & Research Centre Riyadh Saudi Arabia

4. College of Medicine, Alfaisal University Riyadh Saudi Arabia

5. Department of Medicine McMaster University Hamilton Ontario Canada

6. Department of Health Research Methods, Evidence, and Impact McMaster University Hamilton Ontario Canada

7. Department of Critical Care College of Medicine, King Saud University Riyadh Saudi Arabia

8. Research Institute of St. Joseph's Hamilton Hamilton Ontario Canada

9. Population Health Research Institute Hamilton Ontario Canada

Abstract

AbstractBackgroundThe Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach is the de facto standard framework for summarising evidence in systematic reviews and developing recommendations in clinical practice guidelines.MethodsWe describe how the GRADE approach is used in clinical practice guidelines, including key points and examples. The intended audience of this overview of GRADE is clinicians and researchers who are, or plan to be, involved in the development or assessment of clinical practice guidelines.ResultsWe cover guideline endorsement and adaptation; guideline panels and sponsors; conflicts of interest; guideline questions and outcome prioritisation; systematic review creation, updating and re‐use; rating the overall certainty of evidence; development of recommendations and implications; and peer review, publication, implementation and updating of guidelines.ConclusionsThis overview aims to help developers, assessors and users of clinical practice guidelines understand how trustworthy, high‐quality guidelines are developed using the GRADE approach.

Publisher

Wiley

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