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GRADE guidelines: 8. Rating the quality of evidence-indirectness

Guyatt, Gordon H. and Oxman, Andrew D. and Kunz, Regina and Woodcock, James and Brozek, Jan and Helfand, Mark and Alonso-Coello, Pablo and Falck-Ytter, Yngve and Jaeschke, Roman and Vist, Gunn and Akl, Elie A. and Post, Piet N. and Norris, Susan and Meerpohl, Joerg and Shukla, Vijay K. and Nasser, Mona and Schünemann, Holger J. and Grade Working Group, . (2011) GRADE guidelines: 8. Rating the quality of evidence-indirectness. Journal of clinical epidemiology, Vol. 64, H. 12. pp. 1303-1310.

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Official URL: http://edoc.unibas.ch/dok/A6004684

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Abstract

Direct evidence comes from research that directly compares the interventions in which we are interested when applied to the populations in which we are interested and measures outcomes important to patients. Evidence can be indirect in one of four ways. First, patients may differ from those of interest (the term applicability is often used for this form of indirectness). Secondly, the intervention tested may differ from the intervention of interest. Decisions regarding indirectness of patients and interventions depend on an understanding of whether biological or social factors are sufficiently different that one might expect substantial differences in the magnitude of effect. Thirdly, outcomes may differ from those of primary interest-for instance, surrogate outcomes that are not themselves important, but measured in the presumption that changes in the surrogate reflect changes in an outcome important to patients. A fourth type of indirectness, conceptually different from the first three, occurs when clinicians must choose between interventions that have not been tested in head-to-head comparisons. Making comparisons between treatments under these circumstances requires specific statistical methods and will be rated down in quality one or two levels depending on the extent of differences between the patient populations, co-interventions, measurements of the outcome, and the methods of the trials of the candidate interventions.
Faculties and Departments:03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Versicherungsmedizin > Versicherungsmedizin (Kunz)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Versicherungsmedizin > Versicherungsmedizin (Kunz)
UniBasel Contributors:Kunz, Regina
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Pergamon Press
ISSN:0895-4356
Note:Publication type according to Uni Basel Research Database: Journal article
Identification Number:
Last Modified:06 Dec 2013 09:36
Deposited On:06 Dec 2013 09:36

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