Evidence, values and context preferences to help mitigate disputes and enhance the applicability of guideline recommendations to practice

ID: 

19048

Session: 

Short oral session 9: Guideline development B

Date: 

Thursday 14 September 2017 - 16:00 to 17:30

Location: 

Meeting Room 1.63

All authors in correct order:

Parmelli E1, Capobussi M2, Gonzalez-Lorenzo M2, Puljak L3, Riva N4, Squizzato A5, Moja L2
1 Department of Epidemiology Lazio Region-ASL Roma1, Italy
2 Department of Biomedical Sciences for Health, University of Milan, Italy
3 Cochrane Croatia, University of Split School of Medicine, Croatia
4 Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Malta
5 Research Center on Thromboembolic Disorders and Antithrombotic Therapies, Department of Medicine and Surgery, University of Insubria, Italy
Presenting author and contact person

Presenting author:

Livia Puljak

Contact person:

Elena Parmelli
Livia Puljak
Abstract text
Background: Overlapping systematic reviews (SRs) are increasingly frequent in the medical literature. They can easily originate discordant evidence. Reconciling conflicting evidence is a dimension not sufficiently addressed by guideline-development tools. As part of a wider research project supported by the Italian Ministry of Health, we are carrying out a survey to learn more about discordant SRs and their impact on the development of clinical recommendations (CRs).

Objectives: To identify key dimensions and informational needs that could be useful in dealing with discordant evidence in the context of the guideline decision-making process.

Methods: The survey consists of two parts. In the first one general information about the respondents is collected (ie. age, role, expertise, etc…). In the second one we present 4 GRADE Summary of Findings (SoF) tables summarising the results of 4 overlapping discordant SRs and 10 questions investigating the use of the evidence presented to take a decision about a possible CR. Moving from a real scenario, we explore the information needs when dealing with potential discordant evidence.

Results: The survey was sent to 80 people involved at different levels in the development of CRs. To date it has been completed by the 40% of the contacted people. First results show that the most-wanted information when in the presence of overlapping SRs are (multiple choice possible): Risk of Bias of SRs (69,2%); consistency between studies' results (65,4%); included studies in each SR (61,5%); and, methodological limitations in primary studies (50%).

Any response rate above 50% would be considered sufficient for a descriptive study. We will send a maximum of 3 reminders in a 2-month period.

Conclusions: The answers to the survey will help in identifying key dimensions and information needed when in presence of overlapping, discordant SRs. This will be used to develop a new module (Discordant Module) of the GRADE Working Group Guideline Development Tool (GDT - http://gdt.guidelinedevelopment.org) designed to support guideline developers in dealing with overlapping and discordant evidence.