Organization | Criteria for considered judgment | Process |
---|---|---|
CBO | Clinical relevance Safety Patient perspective Professional perspective Available resources Cost-effectiveness Organization of care Legal consequences Ethical considerations Commercial interest | Considered judgment is described after description of the evidence. Formulation of the recommendation is based on the evidence and the considered judgment. A checklist is available for the development group with detailed criteria within ten domains as listed in this table. |
CSP | Strength of evidence Clinical relevance and applicability of evidence Acceptability to patients Benefits and risks Costs | Development group should discuss considerations. When possible quantitative analysis should be made to estimate relative risks and benefits. Guideline document should describe some of the discussion and clearly describe the link between evidence review and recommendations. |
NHMRC | Applicability of the evidence Probable outcome of intervention Balance of benefits against risks Alternative interventions Economic appraisal | A balance sheet is described to balance benefits and harms. |
NZGG | Volume of evidence Consistency of the evidence Applicability of the evidence Clinical impact of the intervention | A considered judgment form is used to link clinical questions, evidence and recommendation. The development group needs to make a decision at the beginning of the process about how to resolve differences. |
SIGN | Quantity, quality and consistency of evidence Generalizability of study findings Directness of application to target population Clinical impact Implementability | Development group summarizes view of considered judgment using a form to record their main points. The level of evidence is assigned to the judgment and a graded recommendation is formulated. |
USPSTF | Quality of studies, linkage to key question using 3 criteria (internal validity, external validity, consistency), linkage to entire preventive service Magnitude and weighing of benefits and harms Extrapolation and generalization Other issues as cost effectiveness, resource prioritization, logistical factors, ethical and legal concerns, patient and societal expectations should be considered, but recommendations reflect primarily the state of the evidence. | Guideline topic team assesses criteria using systematic methods and rating systems. Recommendations reflect primarily the state of evidence. Making recommendations is done with the understanding that clinicians and policymakers must still consider additional factors in making their own decisions. Setting priorities in clinical practice (e.g. based on resource requirements) are beyond the scope of the review. |