Document Detail

Methodology for development of the Allergic Rhinitis and its Impact on Asthma guideline 2008 update.
MedLine Citation:
PMID:  18053015     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: We describe the methodology for the 2008 update of the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines. The methodology differs from the 2001 edition in several respects. The most prominent change is the application of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to compiling evidence, assessing the quality of evidence and grading of recommendations. METHODS AND RESULTS: Representatives of the GRADE working group joined the ARIA guideline panel to achieve these tasks. While most recommendations result from existing systematic reviews, systematic reviews were not always available and the panel compiled the best available evidence in evidence profiles without conducting actual reviews. The panel conducted two meetings and used the GRADE criteria to assess the quality of evidence (four categories of high, moderate, low and very low) and the strength of recommendation (strong and weak) based on weighing up the desirable and undesirable effects of management strategies, considering values and preferences influencing recommendations, and resource implications. The guideline panel has chosen the words 'we recommend'--for strong recommendations and 'we suggest'--for weak recommendations. Both categories indicate the best course of action for a given patient population, but their implementation, requires different considerations as we describe subsequently in this article. CONCLUSIONS: The 2008 update of the ARIA guidelines has become more evidence-based. Future iterations of the guidelines will further be improved by following the described processes even closer, such as ensuring availability of updated high quality systematic reviews for each question.
J L Brozek; C E Baena-Cagnani; S Bonini; G W Canonica; G Rasi; R G van Wijk; T Zuberbier; G Guyatt; J Bousquet; H J Schünemann
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Allergy     Volume:  63     ISSN:  1398-9995     ISO Abbreviation:  Allergy     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2007-12-06     Completed Date:  2008-01-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7804028     Medline TA:  Allergy     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  38-46     Citation Subset:  IM    
S.C. Epidemiologia, Italian National Cancer Institute Regina Elena, Rome, Italy.
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MeSH Terms
Asthma / diagnosis*,  therapy
Evidence-Based Medicine / standards
Practice Guidelines as Topic / standards*
Rhinitis, Allergic, Perennial / diagnosis*,  therapy*
Sensitivity and Specificity

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