Abstract
BackgroundHealthcare decision makers face challenges when using guidelines, including understanding the quality of the evidence or the values and preferences upon which recommendations are made, which are often not clear.MethodsGRADE is a systematic approach towards assessing the quality of evidence and the strength of recommendations in healthcare. GRADE also gives advice on how to go from evidence to decisions. It has been developed to address the weaknesses of other grading systems and is now widely used internationally. The Developing and Evaluating Communication Strategies to Support Informed Decisions and Practice Based on Evidence (DECIDE) consortium (http://www.decide-collaboration.eu/), which includes members of the GRADE Working Group and other partners, will explore methods to ensure effective communication of evidence-based recommendations targeted at key stakeholders: healthcare professionals, policymakers, and managers, as well as patients and the general public. Surveys and interviews with guideline producers and other stakeholders will explore how presentation of the evidence could be improved to better meet their information needs. We will collect further stakeholder input from advisory groups, via consultations and user testing; this will be done across a wide range of healthcare systems in Europe, North America, and other countries. Targeted communication strategies will be developed, evaluated in randomized trials, refined, and assessed during the development of real guidelines.DiscussionResults of the DECIDE project will improve the communication of evidence-based healthcare recommendations. Building on the work of the GRADE Working Group, DECIDE will develop and evaluate methods that address communication needs of guideline users. The project will produce strategies for communicating recommendations that have been rigorously evaluated in diverse settings, and it will support the transfer of research into practice in healthcare systems globally.
Highlights
Healthcare decision makers face challenges when using guidelines, including understanding the quality of the evidence or the values and preferences upon which recommendations are made, which are often not clear
Clinical practice guidelines are becoming increasingly popular, i.e., statements that include recommendations intended to optimize patient care that should be informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options [13,14]
A recent framework for guideline implementability [30] does, support many of the approaches taken by Decisions and Practice Based on Evidence (DECIDE), for example, tailoring guidelines for different types of user, grading evidence, presenting research evidence in a range of formats, considering how recommendations are presented, improved navigation, presenting information on patients’ and others’ preferences and values, information on costs, and providing information to support shared decisions between patients and clinicians
Summary
The DECIDE project has organized its empirical work around five work packages (WPs), each aimed at a different stakeholder group or type of recommendation: health professionals (WP1); policymakers and managers (WP2); public, patients and carers (WP3); diagnostic tests (WP4); and health system policies (WP5). As part of the DECIDE project, we will further develop GRADEpro to incorporate presentations (including recommendations, text, tables and, if appropriate, figures) developed in the five empirical work packages described above (i.e., WPs 1 to 5) to support communication to health professionals, policymakers, and members of the public, as appropriate. These can be provided as help using hypertext links in, for example, online guidelines, as resources or a help file on guideline producers’ websites or in resources, such as the Cochrane Library, as an open access online resource, or as an introduction to a group making recommendations or decisions The objective of this interactive work is to improve understanding and use of evidence of the effects of healthcare interventions by developing products (e.g., interactive Summary of Findings Tables) that allows producers to tailor a presentation to different target audiences and for users to interact with the presentation. These will include access to decision aids at the point of care, to be used in consultations with their clinicians, and tools to assist guideline developers in developing versions of guidelines that are accessible to targeted patients
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