Users'guides to the medical literature. XVI. How to use a treatment recommendation.
Clinicians can often find treatment recommendations in traditional narrative reviews and the discussion sections of original articles and metaanalyses.
Making a treatment recommendation involves framing a question, identifying management options and outcomes, collecting and summarizing evidence, and applying value judgments or preferences to arrive at an optimal course of action.
Each step in this process can be conducted systematically (thus protecting against bias) or unsystematically (leaving the process open to bias).
Clinicians faced with a plethora of recommendations may wish to attend to those that are less likely to be biased.
Therefore, we propose a hierarchy of rigor of recommendations to guide clinicians when judging the usefulness of particular recommendations.
Recommendations with the highest rigor consider all relevant options and outcomes, include a comprehensive collection of the methodologically highest quality data with an explicit strategy for summarizing the data (that is, a systematic review), and make an explicit statement of the values or preferences involved in moving from evidence to action.
High rigor recommendations come from systematically developed, evidence-based practice guidelines or rigorously conducted decision analyses.
Systematic reviews, which typically do not consider all relevant options and outcomes or make the preferences underlying recommendations explicit, offer intermediate rigor recommendations. (...)
Mots-clés Pascal : Canada, Amérique du Nord, Amérique, Homme, Personnel sanitaire, Médecin, Pratique professionnelle, Utilisation information, Recommandation, Protocole thérapeutique, Document publié, Source information, Médecine factuelle
Mots-clés Pascal anglais : Canada, North America, America, Human, Health staff, Physician, Professional practice, Information use, Recommendation, Therapeutic protocol, Published document, Information source, Evidence-based medicine
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0289333
Code Inist : 002B02A07. Création : 16/11/1999.