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Introduction to the GRADE approach for guideline development : considerations for physical therapist practice

AUSTIN TM; RICHTER RR; SEBELSKI CA
PHYS THER , 2014, vol. 94, n° 11, p. 1652-1659
Doc n°: 172023
Localisation : Documentation IRR

D.O.I. : http://dx.doi.org/DOI:10.2522/ptj.20130627
Descripteurs : KA - KINESITHERAPIE, HF3 - FORMATION - PROFESSIONNELS DE SANTE

Practice guidelines (guidelines) have an increasing role in health
care delivery and are being published more frequently.
The Grading of
Recommendations Assessment, Development and Evaluation (GRADE) is an approach for
guideline development. The GRADE approach has been adopted by multiple national
and international organizations producing guidelines related to physical
therapist care. The purpose of this article is to introduce physical
therapists to the GRADE approach for guideline development. RESULTS: GRADE
provides a consistent approach for guideline development and transparency in the
communication of how the guidelines were developed and how the recommendations
were reached, leading to informed choices by patients, clinicians, and policy
makers in health care. GRADE leads to a clear distinction between the strength of
the evidence and the recommendation. Both the direction (for or against) and the
strength (weak or strong) of the recommendation are considered. For determining
the strength of the recommendation, GRADE takes into account the quality of
evidence, the balance of benefit and harm, uncertainty about or variability in
patients' values and preferences, and uncertainty about whether the intervention
is a wise use of resources. LIMITATIONS: The GRADE approach has been used
primarily with interventions and clinical questions and less often with questions
related to diagnosis and prognosis. CONCLUSIONS: The frequency of publication of
guidelines is increasing. To make informed choices in the health care system,
physical therapists should understand how guidelines are developed. The GRADE
approach has been adopted by national and international organizations that
produce guidelines relevant to physical therapist practice. Understanding the
GRADE approach will enable physical therapists to make informed clinical choices.
CI - (c) 2014 American Physical Therapy Association.

Langue : ANGLAIS

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