Do clinicians want recommendations? A multicenter study comparing evidence summaries with and without GRADE recommendations
Artículo
![Thumbnail](/themes/Mirage2/images/cubierta.jpg)
Open/ Download
Publication date
2018Metadata
Show full item record
Cómo citar
Neumann, Ignacio
Cómo citar
Do clinicians want recommendations? A multicenter study comparing evidence summaries with and without GRADE recommendations
Author
- Neumann, Ignacio;
- Alonso Coello, Pablo;
- Olav Vandvik, Per;
- Agoritsas, Thomas;
- Mas, Gemma;
- Akl, Elie;
- Brignardello Petersen, Romina;
- Emparanza, José;
- McCullagh, Lauren;
- De Sitio, Catherine;
- McGinn, Thomas;
- Almodaimegh, Hind;
- Almodaimegh, Khalid;
- Rivera, Solange;
- Roja, Luis;
- Stirnemann, Jérôme;
- Irani, Jihad;
- Hlais, Sani;
- Mustafa, Reem;
- Bdair, Fadi;
- Aly, Abdelrahman;
- Kristiansen, Annette;
- Izcovich, Ariel;
- Ramirez, Anggie;
- Brozek, Jan;
- Guyatt, Gordon H.;
- Sch€unemann, Holger;
Abstract
Objectives: Evidence-based clinical practice guidelines provide recommendations to assist clinicians in decision-making and to reduce
the gap between best current research evidence and clinical practice. However, some argue that providing preappraised evidence summaries
alone, rather than recommendations, is more appropriate. The objective of the study is to evaluate clinicians’ preferences, and understanding of the evidence and intended course of action in response to evidence summaries with and without recommendations.
Study Design Setting: We included practicing clinicians attending educational sessions across 10 countries. Clinicians were randomized to receive relevant clinical scenarios supported by research evidence of low or very low certainty and accompanied by either strong or weak recommendations developed with the GRADE system. Within each group, participants were further randomized to receive the recommendation plus the corresponding evidence summary or the evidence summary alone. We evaluated participants’ preferences and understanding for the presentation strategy, as well as their intended course of action.
Results: One hundred eighty-nine of 219 (86%) and 201 of 248 (81%) participants preferred having recommendations accompanying
evidence summaries for both strong and weak recommendations, respectively. Across all scenarios, less than half of participants correctly
interpreted information provided in the evidences summaries (e.g., estimates of effect, certainty in the research evidence). The presence of a
recommendation resulted in a more appropriate intended course of action for two scenarios involving strong recommendations.
Conclusion: Evidence summaries alone are not enough to impact clinicians’ course of action. Clinicians clearly prefer having recommendations accompanying evidence summaries in the context of low or very low certainty of evidence (Trial registration
NCT02006017).
Indexation
Artículo de publicación SCOPUS
Identifier
URI: https://repositorio.uchile.cl/handle/2250/159156
DOI: 10.1016/j.jclinepi.2018.02.026
ISSN: 18785921
08954356
Quote Item
Journal of Clinical Epidemiology, Volumen 99, 2018, Pages 33-40.
Collections