IDSA guidelines classification scheme: Difference between revisions
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==IDSA Updated Guidelines Classification Scheme 2016== | ==IDSA Updated Guidelines Classification Scheme 2016<ref name="PappasKauffman2015">{{cite journal|last1=Pappas|first1=Peter G.|last2=Kauffman|first2=Carol A.|last3=Andes|first3=David R.|last4=Clancy|first4=Cornelius J.|last5=Marr|first5=Kieren A.|last6=Ostrosky-Zeichner|first6=Luis|last7=Reboli|first7=Annette C.|last8=Schuster|first8=Mindy G.|last9=Vazquez|first9=Jose A.|last10=Walsh|first10=Thomas J.|last11=Zaoutis|first11=Theoklis E.|last12=Sobel|first12=Jack D.|title=Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America|journal=Clinical Infectious Diseases|year=2015|pages=civ933|issn=1058-4838|doi=10.1093/cid/civ933}}</ref>== | ||
==Level of Evidence== | ==Level of Evidence== | ||
Based on the different variables taken into account the level of evidence is rated by IDSA | Based on the different variables taken into account the level of evidence is rated by IDSA as follows: | ||
===Factors favoring higher level of confidence:=== | ===Factors favoring higher level of confidence:=== | ||
| Line 40: | Line 40: | ||
* Dose Response | * Dose Response | ||
* All plausible confounding and bias would reduce a demonstrated effect or would suggest a spurious effect if no effect was observed. | * All plausible confounding and bias would reduce a demonstrated effect or would suggest a spurious effect if no effect was observed. | ||
===Factors favoring | ===Factors favoring low level level of confidence:=== | ||
* Observational Studies | * Observational Studies | ||
* Risk of Bias | * Risk of Bias | ||
| Line 47: | Line 47: | ||
* Imprecision | * Imprecision | ||
* Publication Bias | * Publication Bias | ||
''' | ===Based on these considerations of the level of confidence the level of evidence is rated as follows:=== | ||
*'''Strong''' | |||
''' | *'''Moderate''' | ||
'''Very Low''' | *'''Low''' | ||
*'''Very Low''' | |||
==Strength of Recommendation== | ==Strength of Recommendation== | ||
===Determinants of Strength of Recommendation=== | ===Determinants of Strength of Recommendation=== | ||
* Quality of Evidence | |||
* Balance between benefits, harms and burdens | |||
* Patients values and preferences | |||
* Resources and cost | |||
===Implication of Strength of Recommendation=== | |||
====Strong Recommendation==== | |||
* Population : Most people in this situation would want the recommended course of action and only a small proportion would not. | |||
* Healthcare workers: Most people should receive the recommended course of action. | |||
* Policy makers: The recommendation can be adopted as a policy in most situations. | |||
====Weak Recommendation==== | |||
* Population : Majority of the people in this situation would want the recommended course of action, but many would not . | |||
* Healthcare workers: Be prepared to help people to make a decision that is consistent with their values/decision aids and shared decision making. | |||
* Policy makers: There is a need for substantial debate and involvement of stakeholders. | |||
==IDSA 2016 Guidelines== | |||
[[File:Screen Shot 2017-01-06 at 11.21.14 am.png]] | [[File:Screen Shot 2017-01-06 at 11.21.14 am.png]] | ||
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[[File:Screen Shot 2017-01-06 at 11.21.47 am.png]] | [[File:Screen Shot 2017-01-06 at 11.21.47 am.png]] | ||
==References== | |||
{{Reflist|2}} | |||
Latest revision as of 21:41, 6 January 2017
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Strength of Recommendations
Class A
Good evidence to support a recommendation for or against use.
Class B
Moderate evidence to support a recommendation for or against use.
Class C
Poor evidence to support a recommendation.
Quality of Evidence
Level of Evidence I
Evidence from ≥1 properly randomized, controlled trial.
Level of Evidence II
Evidence from ≥1 well-designed clinical trial, without randomization; from cohort or case-controlled analytic studies (preferably from >1 center); from multiple time-series; or from dramatic results from uncontrolled experiments.
Level of Evidence III
Evidence from opinions of respected authorities, based on clinical experience, descriptive studies, or reports of expert committees.
Applying Strength of Recommendations and Quality of Evidence
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 |
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IDSA Updated Guidelines Classification Scheme 2016[1]
Level of Evidence
Based on the different variables taken into account the level of evidence is rated by IDSA as follows:
Factors favoring higher level of confidence:
- Randomized trails
- Large Effect
- Dose Response
- All plausible confounding and bias would reduce a demonstrated effect or would suggest a spurious effect if no effect was observed.
Factors favoring low level level of confidence:
- Observational Studies
- Risk of Bias
- Inconsistency
- Indirectness
- Imprecision
- Publication Bias
Based on these considerations of the level of confidence the level of evidence is rated as follows:
- Strong
- Moderate
- Low
- Very Low
Strength of Recommendation
Determinants of Strength of Recommendation
- Quality of Evidence
- Balance between benefits, harms and burdens
- Patients values and preferences
- Resources and cost
Implication of Strength of Recommendation
Strong Recommendation
- Population : Most people in this situation would want the recommended course of action and only a small proportion would not.
- Healthcare workers: Most people should receive the recommended course of action.
- Policy makers: The recommendation can be adopted as a policy in most situations.
Weak Recommendation
- Population : Majority of the people in this situation would want the recommended course of action, but many would not .
- Healthcare workers: Be prepared to help people to make a decision that is consistent with their values/decision aids and shared decision making.
- Policy makers: There is a need for substantial debate and involvement of stakeholders.
IDSA 2016 Guidelines
References
- ↑ Pappas, Peter G.; Kauffman, Carol A.; Andes, David R.; Clancy, Cornelius J.; Marr, Kieren A.; Ostrosky-Zeichner, Luis; Reboli, Annette C.; Schuster, Mindy G.; Vazquez, Jose A.; Walsh, Thomas J.; Zaoutis, Theoklis E.; Sobel, Jack D. (2015). "Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America". Clinical Infectious Diseases: civ933. doi:10.1093/cid/civ933. ISSN 1058-4838.