Recommendations per disease - COMPAR-EU

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Recommendations

In this section, we present the “Recommendations” for the four chronic conditions: Type 2 diabetes mellitus, obesity, COPD and Heart failure.

The strength of a recommendation reflects the extent to which a guideline panel is confident that desirable effects of an intervention outweigh undesirable effects, or vice versa, across the range of patients for whom the recommendation is intended.

All the recommendations have been performed using the GRADE approach with the participation of a panel of experts including patient representatives.

GRADE specifies two categories of the strength of a recommendation. While GRADE suggests using the terms strong and weak recommendations, those making recommendations may choose different wording to characterize the two categories of strength.

Strong Recommendation= “We recommend to use or not to use the intervention”
Conditional Recommendation = “We suggest to use or not to use the intervention”

If you want to learn more about the wording of recommendations, please visit:

GRADE handbook

Implications of the recommendations categories for each stakeholder.

Implications of strong and weak recommendations for different users of guidelines

Strong Recommendation

Conditional Recommendation

For patients

Most individuals in this situation would want the recommended course of action and only a small proportion would not.

The majority of individuals in this situation would want the suggested course of action, but many would not.

For clinicians

Most individuals should receive the recommended course of action. Adherence to this recommendation according to the guideline could be used as a quality criterion or performance indicator. Formal decision aids are not likely to be needed to help individuals make decisions consistent with their values and preferences.

Recognize that different choices will be appropriate for different patients, and that you must help each patient arrive at a management decision consistent with her or his values and preferences. Decision aids may well be useful helping individuals making decisions consistent with their values and preferences. Clinicians should expect to spend more time with patients when working towards a decision.

For policy makers

The recommendation can be adapted as policy in most situations including for the use as performance indicators.

Policy making will require substantial debates and involvement of many stakeholders. Policies are also more likely to vary between regions. Performance indicators would have to focus on the fact that adequate deliberation about the management options has taken place.

The GRADE handbook, chapter 6 Going from evidence to recommendations. Table 6.1

If you want to learn more about the Recommendations methodology, please visit:
Gradepro Handbook Recommendations

If you want to learn more about the GRADE methodology you can visit:
GRADE What it is?

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