Required knowledge for guideline panel members to develop healthcare related testing recommendations: a developmental study.

Objectives: To define the minimum knowledge required for guideline panel members (healthcare professionals and consumers) involved in developing recommendations about healthcare related testing.

Study Design And Setting: A developmental study with a multistaged approach. We derived a first set of knowledge components from literature and subsequently performed semistructured interviews with 9 experts.

GRADE guidance 36: updates to GRADE's approach to addressing inconsistency.

Objectives: To update previous Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidance by addressing inconsistencies and interpreting subgroup analyses.

Study Design And Setting: Using an iterative process, we consulted with members of the GRADE working group through multiple rounds of written feedback and discussions at GRADE working group meetings.

Results: The guidance complements previous guidance with clarification in two areas: (1) assessing inconsistency and (2) assessing the credibility of possible effect modifiers that might explain inconsistency.

GRADE guidance 35: update on rating imprecision for assessing contextualized certainty of evidence and making decisions.

Objectives: Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidance to rate the certainty domain of imprecision is presently not fully operationalized for rating down by two levels and when different baseline risk or uncertainty in these risks are considered. In addition, there are scenarios in which lowering the certainty of evidence by three levels for imprecision is more appropriate than lowering it by two levels. In this article, we conceptualize and operationalize rating down for imprecision by one, two and three levels for imprecision using the contextualized GRADE approaches and making decisions.

Applying GRADE for diagnosis revealed methodological challenges: an illustrative example for guideline developers.

Objective: To identify challenges in the application of GRADE for diagnosis when assessing the certainty of evidence in the test-treatment strategy (diagnostic accuracy, test burden, management effectiveness, natural course, linked evidence) in an illustrative example and to propose solutions to these challenges.

Study Design And Setting: A case study in applying GRADE for diagnosis that looked at the added value of IgE for diagnosing allergic rhinitis.

Results: Evaluation of the full test-treatment strategy showed a lack of (high-quality) evidence for all elements.

GRADE guidelines 26: informative statements to communicate the findings of systematic reviews of interventions.

Objectives: Clear communication of systematic review findings will help readers and decision makers. We built on previous work to develop an approach that improves the clarity of statements to convey findings and that draws on Grading of Recommendations Assessment, Development and Evaluation (GRADE).

Study Design And Setting: We conducted workshops including 80 attendants and a survey of 110 producers and users of systematic reviews.

Facilitating healthcare decisions by assessing the certainty in the evidence from preclinical animal studies.

Laboratory animal studies are used in a wide range of human health related research areas, such as basic biomedical research, drug research, experimental surgery and environmental health. The results of these studies can be used to inform decisions regarding clinical research in humans, for example the decision to proceed to clinical trials. If the research question relates to potential harms with no expectation of benefit (e.

GRADE equity guidelines 1: considering health equity in GRADE guideline development: introduction and rationale.

Objectives: This article introduces the rationale and methods for explicitly considering health equity in the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology for development of clinical, public health, and health system guidelines.

Study Design And Setting: We searched for guideline methodology articles, conceptual articles about health equity, and examples of guidelines that considered health equity explicitly. We held three meetings with GRADE Working Group members and invited comments from the GRADE Working Group listserve.

The biological standard of living in Suriname, c. 1870-1975.

The physical stature of Surinamese soldiers is estimated to have increased by more than 3cm between 1870 and 1909. In the subsequent four decades, the increase in adult male and female height amounted to 0.3-0.

How to generalize efficacy results of randomized trials: recommendations based on a systematic review of possible approaches.

Rationale, Aims And Objectives: Randomized controlled trials (RCTs) are the preferred source for evidence for the effect of treatment. However, patients participating in RCTs often manifest important differences from patients seen in practice. Therefore, guideline developers have to decide whether the results are generalizable to the target population not represented in RCTs.

Dairy products and physical stature: a systematic review and meta-analysis of controlled trials.

The positive relationship between per capita availability of dairy products and average height found in historical studies (for instance in nineteenth century Bavaria, Prussia and France; Baten, 2009) does not necessarily indicate a causal relationship. Historical studies usually apply non-experimental methods that may produce substantial bias. Modern experimental controlled studies may provide high quality evidence supporting a causal relationship between consumption of dairy products and physical growth.

GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables.

This article is the first of a series providing guidance for use of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system of rating quality of evidence and grading strength of recommendations in systematic reviews, health technology assessments (HTAs), and clinical practice guidelines addressing alternative management options. The GRADE process begins with asking an explicit question, including specification of all important outcomes. After the evidence is collected and summarized, GRADE provides explicit criteria for rating the quality of evidence that include study design, risk of bias, imprecision, inconsistency, indirectness, and magnitude of effect.

[Guideline 'Coeliac disease and dermatitis herpetiformis'].

The Dutch evidence-based guideline 'Coeliac disease and dermatitis herpetiformis' contains instructions for detection and treatment of coeliac disease. Coeliac disease has a high prevalence: 0.5 - 1.

[Multidisciplinary guidelines for 'Apparent life threatening event' (ALTE)].

In order to reach a consensus concerning diagnosis, support and follow-up in children with an 'apparent life threatening event' (ALTE) multidisciplinary guidelines have been developed by the Dutch Paediatric Association and the Dutch Institute for Healthcare Improvement (CBO). All children presenting as an emergency with ALTE should undergo inpatient clinical observation for 24-72 h, with at least 24 h of cardio-respiratory monitoring. Observation does not need to be continued once an explanation for the incident has been established.

Observations on the history of Dutch physical stature from the late-Middle Ages to the present.

In the late-Middle Ages and at the onset of the early modern period, the Dutch population was taller than in the first half of the 19th century. This inference is partially based on skeletal evidence, mainly collected by the Dutch physical anthropologist George Maat and his co-workers. A spectacular increase in Dutch heights began in the second half of the 19th century and accelerated in the second half of the 20th century.