1st Guideline Methodology and GRADE Workshop
Tim Raine, GuiCom Member
Tim Raine © ECCO
The upcoming ECCO Congress will see a new addition to the line-up of workshops offered. Under the supervision of the Guidelines Committee (GuiCom), we are running a workshop specifically designed to offer ECCO Members the opportunity to increase their awareness and knowledge of the GRADE clinical guideline development methodology.
Guideline development methodologies should allow experts to assess the evidence for a given clinical problem and then to vote and agree upon a clear statement that presents a synthesis of the evidence. There should also be some sense of the strength of the evidence behind any final recommendations. Previously published ECCO Guidelines have used the Oxford levels of evidence when assessing the strength of evidence. These are easy to use and to understand, but have been criticised for lacking transparency and reproducibility, particularly when multiple, potentially conflicting studies of variable quality are available. The GRADE process is, at its core, a robust and transparent series of steps that can be taken to allow the identification, integration and assessment of all available evidence to support a clinically relevant question. The process starts with the generation of an agreed list of important outcomes for a given topic and the formulation of key clinical questions. These form the basis for a systematic literature review, the results of which are used to extract key evidence for each outcome. This evidence is synthesised and the quality assessed using a standardised scoring process. Finally, the evidence synthesis and quality assessment form the basis for any recommendations.
The ECCO Crohn’s Disease Guidelines currently under development are using the GRADE methodology, and ECCO plans to adopt the GRADE methodology in future guideline projects, where appropriate. Future participants will therefore need to be familiar with the GRADE methods. The upcoming GuiCom Workshop will offer ECCO Members initial exposure to the GRADE principles and also provide an introduction to the wider principles underlying current guideline development. Expert speakers will include Stefanos Bonovas, a GRADE expert from Milan, Italy, as well as the conveners of the present Crohn’s Disease Guidelines project, Joana Torres and Gionata Fiorino. The workshop promises to offer a challenging and informative morning of expert discussion, and participants can expect to gain a deeper understanding of the GRADE process, supporting participation in and understanding of future guideline projects, whether from ECCO or from other societies and in other disease areas. On behalf of the members of GuiCom, we look forward to seeing you in Copenhagen in 2019!