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Systems for grading the strength of recommendations in clinical practice guidelines in oncology
, 1, 1, 1, 1, 1, 1
Affiliations- Agency for Health Technology Assessment and Tariff System, Warsaw, Poland
open access
Abstract
Introduction. In order to improve the applicability of clinical practice guidelines, their authors assign recommendations with grades denoting the degree of conviction regarding their practical application. Nevertheless even within one branch of medicine, significant differences between the grading systems arise.
Material and methods. To identify these systems, websites of societies and institutions publishing oncology guidelines were searched. Only high-quality, regularly updated guidelines were included.
Results. Five systems were analysed – all incorporate quality of evidence and strength of recommendation, but vary in the methods of their assessment and structure of the scales.
Discussion. The described systems depend on the review of data, the quality of which supports the ascribed strength. Systems differ with regard to the methods of assessing the quality, quantity and consistency of evidence, potentially leading to assigning different grades of strength to recommendations based on the same studies.
Conclusions. The introduction of unified grading systems across each branch of medicine could aid the development of unambiguous recommendations that are easy to introduce within the healthcare system.
Abstract
Introduction. In order to improve the applicability of clinical practice guidelines, their authors assign recommendations with grades denoting the degree of conviction regarding their practical application. Nevertheless even within one branch of medicine, significant differences between the grading systems arise.
Material and methods. To identify these systems, websites of societies and institutions publishing oncology guidelines were searched. Only high-quality, regularly updated guidelines were included.
Results. Five systems were analysed – all incorporate quality of evidence and strength of recommendation, but vary in the methods of their assessment and structure of the scales.
Discussion. The described systems depend on the review of data, the quality of which supports the ascribed strength. Systems differ with regard to the methods of assessing the quality, quantity and consistency of evidence, potentially leading to assigning different grades of strength to recommendations based on the same studies.
Conclusions. The introduction of unified grading systems across each branch of medicine could aid the development of unambiguous recommendations that are easy to introduce within the healthcare system.
Keywords
grading system; guidelines; recommendation; quality of evidence; strength of recommendation
About this articleTitle
Systems for grading the strength of recommendations in clinical practice guidelines in oncology
Journal
Nowotwory. Journal of Oncology
Issue
Article type
Guidelines / Expert consensus
Pages
407-416
Published online
2021-12-06
Page views
6014
Article views/downloads
801
DOI
Bibliographic record
Nowotwory. Journal of Oncology 2021;71(6):407-416.
Keywords
grading system
guidelines
recommendation
quality of evidence
strength of recommendation
Authors
Anna Rychert
Dominik Roman Dziurda
Magdalena Koperny
Magdalena Maria Krasztel
Katarzyna Joanna Kędzior
Wojciech Wysoczański
Roman Topór-Mądry
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