| Methodology for the development of antithrombotic therapy and prevention of thrombosis guidelines: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. | |
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MedLine Citation:
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PMID: 22315256 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: To develop the Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: ACCP Evidence-Based Clinical Practice Guidelines (AT9), the American College of Chest Physicians (ACCP) assembled a panel of clinical experts, information scientists, decision scientists, and systematic review and guideline methodologists. METHODS: Clinical areas were designated as articles, and a methodologist without important intellectual or financial conflicts of interest led a panel for each article. Only panel members without significant conflicts of interest participated in making recommendations. Panelists specified the population, intervention and alternative, and outcomes for each clinical question and defined criteria for eligible studies. Panelists and an independent evidence-based practice center executed systematic searches for relevant studies and evaluated the evidence, and where resources and evidence permitted, they created standardized tables that present the quality of the evidence and key results in a transparent fashion. RESULTS: One or more recommendations relate to each specific clinical question, and each recommendation is clearly linked to the underlying body of evidence. Judgments regarding the quality of evidence and strength of recommendations were based on approaches developed by the Grades of Recommendations, Assessment, Development, and Evaluation Working Group. Panel members constructed scenarios describing relevant health states and rated the disutility associated with these states based on an additional systematic review of evidence regarding patient values and preferences for antithrombotic therapy. These ratings guided value and preference decisions underlying the recommendations. Each topic panel identified questions in which resource allocation issues were particularly important and, for these issues, experts in economic analysis provided additional searches and guidance. CONCLUSIONS: AT9 methodology reflects the current science of evidence-based clinical practice guideline development, with reliance on high-quality systematic reviews, a standardized process for quality assessment of individual studies and the body of evidence, an explicit process for translating the evidence into recommendations, disclosure of financial as well as intellectual conflicts of interest followed by management of disclosed conflicts, and extensive peer review. |
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Authors:
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Gordon H Guyatt; Susan L Norris; Sam Schulman; Jack Hirsh; Mark H Eckman; Elie A Akl; Mark Crowther; Per Olav Vandvik; John W Eikelboom; Marian S McDonagh; Sandra Zelman Lewis; David D Gutterman; Deborah J Cook; Holger J Schünemann; |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Chest Volume: 141 ISSN: 1931-3543 ISO Abbreviation: Chest Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2012-02-08 Completed Date: 2012-04-13 Revised Date: 2013-05-10 |
Medline Journal Info:
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Nlm Unique ID: 0231335 Medline TA: Chest Country: United States |
Other Details:
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Languages: eng Pagination: 53S-70S Citation Subset: AIM; IM |
Affiliation:
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Department of Clinical Epidemiology and Biostatistics, McMaster University Faculty of Health Sciences, Hamilton, ON, Canada. guyatt@mcmaster.ca |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Evidence-Based Medicine* Fibrinolytic Agents / therapeutic use* Humans Practice Guidelines as Topic* Societies, Medical* Thrombosis / drug therapy*, prevention & control* United States |
| Grant Support | |
ID/Acronym/Agency:
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UL1 TR000077/TR/NCATS NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Fibrinolytic Agents |
| Comments/Corrections | |
Comment In:
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Chest. 2013 Apr;143(4):1190-1
[PMID:
23546508
]
Chest. 2013 Apr;143(4):1191 [PMID: 23546509 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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