Using explicit thresholds for benefits and harms in partially contextualized GRADE guidelines. Pilot experience from a living COVID-19 guideline

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dc.contributor.authorNeumann, Ignacio
dc.contributor.authorQuinelen, Eduardo
dc.contributor.authorNahuelhual, Paula
dc.contributor.authorBurdiles, Pamela
dc.contributor.authorCeledon, Natalia
dc.contributor.authorCerda, Katherine
dc.contributor.authorHerrera-Omegna, Paloma
dc.contributor.authorKraemer, Patricia
dc.contributor.authorCancino, Karen Dominguez
dc.contributor.authorValenzuela, Juan Pablo
dc.contributor.authorSepulveda, Dino
dc.contributor.authorMorgano, Gian Paolo
dc.contributor.authorAkl, Elie A.
dc.contributor.authorSchunemann, Holger J.
dc.date.accessioned2025-01-20T21:06:07Z
dc.date.available2025-01-20T21:06:07Z
dc.date.issued2022
dc.description.abstractObjectives: Guideline panels must assess the magnitude of health benefits and harms to develop sensible recommendations. However, they rarely use explicit thresholds. In this paper we report on the piloting and the use thresholds for benefits and harms.Study Design and Setting: We piloted the use of thresholds in a Chilean COVID-19 living guideline. For each of the critical outcomes, we asked panelists to suggest values of the thresholds for large, moderate, small, or trivial or no effect. We collected this information through a survey and an on-line discussion.Results: Twelve panelists decided on thresholds for three critical outcomes (mortality, need for mechanical ventilation and serious adverse events). For all outcomes, an absolute risk reduction was considered larger with more than 50 events, moderate with less than 50 events, small with less than 25 events, and trivial with less than 10 events. Having these a priori thresholds in place significantly impacted on the development of recommendations. Conclusion: Explicit thresholds were a valuable addition to the judgment of the certainty in the evidence, to decide the direction and strength of the recommendation and to evaluate the need for update. We believe this is a line of research worth perusing.(c) 2022 Elsevier Inc. All rights reserved.
dc.fuente.origenWOS
dc.identifier.doi10.1016/j.jclinepi.2022.03.017
dc.identifier.eissn1878-5921
dc.identifier.issn0895-4356
dc.identifier.urihttps://doi.org/10.1016/j.jclinepi.2022.03.017
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/93332
dc.identifier.wosidWOS:000808123800003
dc.language.isoen
dc.pagina.final75
dc.pagina.inicio69
dc.revistaJournal of clinical epidemiology
dc.rightsacceso restringido
dc.subjectClinical guidelines
dc.subjectGRADE
dc.subjectCOVID-19
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleUsing explicit thresholds for benefits and harms in partially contextualized GRADE guidelines. Pilot experience from a living COVID-19 guideline
dc.typeartículo
dc.volumen147
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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