IDSA guidelines classification scheme: Difference between revisions
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===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''' === | |||
* 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 === | |||
* 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. | |||
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Revision as of 16:57, 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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IDSA Updated Guidelines Classification Scheme 2016
Level of Evidence
Based on the different variables taken into account the level of evidence is rated by IDSA and it is 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 a low level level of confidence:
- Observational Studies
- Risk of Bias
- Inconsistency
- Indirectness
- Imprecision
- Publication Bias
Based on these considerations 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
- 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
- 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.
