Users of clinical practice guidelines and other recommendations need to know how much confidence they can place in the recommendations. Systematic and explicit methods of making judgments can reduce errors and improve communication. We have developed a system for grading the quality of evidence and the strength of recommendations that can be applied across a wide range of interventions and contexts. In this article we present a summary of our approach from the perspective of a guideline user. Judgments about the strength of a recommendation require consideration of the balance between benefits and harms, the quality of the evidence, translation of the evidence into specific circumstances, and the certainty of the baseline risk. It is also important to consider costs (resource utilisation) before making a recommendation. Inconsistencies among systems for grading the quality of evidence and the strength of recommendations reduce their potential to facilitate critical appraisal and improve communication of these judgments. Our system for guiding these complex judgments balances the need for simplicity with the need for full and transparent consideration.
This article is available in full text at both the U of M and UPR libraries. U of M students, staff and faculty can access it through the MNCAT catalog. UPR students, staff and faculty can access through the ProQuest Medical Library at: http://rcm- library.rcm.upr.edu/ProQuestaccess.htm
LAURA LANDRO, The Wall Street Journal
Thursday, June 17, 2004
(06-17) 06:07 PDT (AP) --
The current push to require drug companies to disclose their unpublished clinical trials could unleash a flood of new information for doctors and patients. But in the meantime, there is already a growing effort by medical publishers, scientific groups and government agencies aimed at helping people find and interpret clinical-trials results online.
Currently existing registries are run by the National Institutes of Health and a host of private organizations. Web sites like MedlinePlus.gov offer direct links to most published medical studies, which in some cases are free or else can be purchased directly from the journal. And more help is under development, such as an upcoming guide from the National Library of Medicine on understanding reports.
By Amanda Gardner
TUESDAY, June 15 (HealthDayNews) -- Three of the nation's leading health organizations have joined forces to release the first unified set of recommendations on how to avert the nation's deadliest diseases.
The guidelines are aimed at preventing cancer, diabetes, heart disease, and stroke, and experts said that if they're followed carefully, people can lower their risk of getting these diseases by two-thirds.
The recommendations, announced Tuesday by the American Heart Association, the American Cancer Society, and the American Diabetes Association, are intended to make life simpler and healthier for all Americans. Lifestyle changes that lower the risk for one disease, for instance, could cut the risk for them all, they said.
The power of the prescription pad is harnessed to the Internet with the hope that educated patients can be powerful players in their own care.
By Susan J. Landers, AMNews staff. May 24/31, 2004.
Washington -- Officially directing patients to a reputable Web site to research a disease or condition is an idea whose time has come, according to physicians who have participated in pilot projects for Prescriptions for Information.
The program, a joint effort of the National Library of Medicine and the American College of Physicians Foundation, encourages physicians to write prescriptions for a trustworthy, commercial-free Web site packed full of free information -- the NLM's MedlinePlus.
"Keeping up-to-date in this age of information overload can be difficult. But not anymore. Mobile Medica has a convenient, cost-effective solution - APPRISOR™. APPRISOR™ is a world class content delivery system specifically designed for medical organizations. In the APPRISOR™ system, Mobile Medica provides a single source for document creation and delivery via our robust and freely distributed document viewers for either Palm OS® or Microsoft Pocket PC handhelds. Each APPRISOR™ document can be read on both Palm OS® or Pocket PC OS systems, and even transferred between the two. APPRISOR™ supports Palm OS® 3.0 and above including OS 5 and Pocket PC 2002 on ARM, XScale, MIPS, or SH3 processors."
This site does require registration, however the downloads are free.
For registration go to: http://www.apprisor.com/information.cfm
For downloads go to: http://www.apprisor.com/dlselect.cfm
The Apprisor reader and the Common ICD9 Codes, 2004 Edition files may be downloaded at the same time. Clinical Practice Guidelines are also available at this site.