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Guideline groups should make recommendations even if the evidence is considered insufficient

Canadian Medical Association journal (CMAJ), 2020-01, Vol.192 (2), p.E23-E24 [Peer Reviewed Journal]

COPYRIGHT 2020 Joule Inc. ;Copyright Joule Inc Jan 13, 2020 ;2020 Joule Inc. or its licensors 2020 ;ISSN: 0820-3946 ;EISSN: 1488-2329 ;DOI: 10.1503/cmaj.190144 ;PMID: 31932336

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  • Title:
    Guideline groups should make recommendations even if the evidence is considered insufficient
  • Author: Neumann, Ignacio ; Schünemann, Holger J
  • Subjects: Bedaquiline ; Clinical medicine ; Evidence-Based Medicine ; Humans ; Intervention ; Medical research ; Medicine, Preventive ; Multidrug resistant organisms ; Parkinsons disease ; Patients ; Practice Guidelines as Topic ; Prevention ; Preventive health services ; Preventive medicine ; Stem cells ; Task forces ; Tuberculosis
  • Is Part Of: Canadian Medical Association journal (CMAJ), 2020-01, Vol.192 (2), p.E23-E24
  • Description: Clinicians and patients often face situations in which the evidence to support a proposed intervention is sparse or doubtful--sometimes called insufficient evidence. Some guideline developers are reluctant to make concrete recommendations when evidence is deemed insufficient. For example, the US Preventive Services Task Force has a special category called I statement (for insufficient evidence),1 which allows them to avoid recommending an intervention that may be proven ineffective or harmful in the future. Guideline panellists may perceive recommendations based on little or no evidence as not evidence based and therefore unfounded. Although the cautious approach taken by guideline panels is understandable, a recent randomized trial, in which more than 500 clinicians were presented with clinical scenarios informed by sparse evidence, found that more than 80% of clinicians preferred receiving a recommendation. Clinicians strongly prefer having recommendations in the context of uncertainty.
  • Publisher: Canada: Joule Inc
  • Language: English
  • Identifier: ISSN: 0820-3946
    EISSN: 1488-2329
    DOI: 10.1503/cmaj.190144
    PMID: 31932336
  • Source: ProQuest One Psychology
    GFMER Free Medical Journals
    MEDLINE
    PubMed Central
    Alma/SFX Local Collection
    ProQuest Central
    DOAJ Directory of Open Access Journals
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