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Clinical Practice Guideline Development: Key Factors to Consider Using GRADE


Clinical practice guidelines make recommendations about many aspects of patient care: risk assessment, diagnosis, prognosis, treatment, monitoring, and follow-up. Some recommendations are underpinned by strong evidence, whereas for others the evidence is either tentative, or the clinical consensus alone may be strong enough to support a "good practice statement."

GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) is one structured system that some guideline developers use. GRADE encourages full transparency about all considerations that influence each recommendation rating, including both evidentiary factors (e.g., study limitations, inconsistency, imprecision) and non-evidentiary factors (e.g., patient preferences, feasibility, acceptability, resource use).

Many guideline developers use GRADE, but others do not. This 30-minute webinar, presented by two experienced GRADE professionals from the ECRI-Penn Evidence-based Practice Center, will provide a broad overview of the GRADE system and highlight key factors for developers to consider when deciding whether to adopt or modify GRADE for their guidelines.

Learning Objectives

During this webinar, we will:
1. Describe the general purpose of rating the strength of recommendations in clinical practice guidelines.
2. Summarize the GRADE system and its primary components.
3. Outline key factors influencing guideline developers in deciding whether to adopt GRADE.

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Jonathan R. Treadwell, PhD

Codirector of the ECRI-Penn Evidence-based Practice Center
Jonathan R. Treadwell joined ECRI in 2000, has conducted numerous systematic reviews and meta-analyses, and is an expert in the methods of evidence assessment. He has cotaught GRADE training workshops at the New York Academy of Medicine, and tailored GRADE seminars for guideline developers. Dr. Treadwell has also held evidence-based medicine workshops with clients at ECRI headquarters, and for Doctors Without Borders, the World Health Organization, and Health Technology Assessment International. 

Stacey Uhl, MS

Associate Director, Evidence Contracts and Consulting, ECRI
Stacey Uhl has been with ECRI's Evidence-based Practice Center and Center for Clinical Evidence and Guidelines for over 15 years. She has extensive experience in conducting systematic reviews and has led several large-scale systematic reviews to support the development of clinical practice guidelines for government agencies including the US Department of Veterans Affairs and the Department of Defense and for professional medical societies including the American College of Rheumatology and American College of Physicians. She works closely with guideline panel members to facilitate the translation of evidence into clinical practice recommendations. Ms. Uhl has led and cotaught several training workshops on various topics related to systematic review methodology, including the use of GRADE.