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Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Application of GRADE: Making evidence-based recommendations about diagnostic tests in clinical practice guidelines | Hsu et al. Implementation Science 2011 6 62 http www.implementationscience.eom content 6 1 62 Implementation Science IMPLEMENTATION SCIENCE METHODOLOGY Open Access Application of GRADE Making evidence-based recommendations about diagnostic tests in clinical practice guidelines I z-v k . s I . s k . I_Ir-I I1 I i I D r 7 J 2 I I 11 I T rm I n CS 3 11 11 I I If I r 4 c k I 15 A I fs I Fz I L f m c Z I 6 Jonathan Hsu Jan L BrozeK Luigi lerracciano Julia Kleis Enrico Compalati Airton letelbom Stein Alessandro Fiocchi3 and Holger J Schunemann1 2 Abstract Background Accurate diagnosis is a fundamental aspect of appropriate healthcare. However clinicians need guidance when implementing diagnostic tests given the number of tests available and resource constraints in healthcare. Practitioners of health often feel compelled to implement recommendations in guidelines including recommendations about the use of diagnostic tests. However the understanding about diagnostic tests by guideline panels and the methodology for developing recommendations is far from completely explored. Therefore we evaluated the factors that guideline developers and users need to consider for the development of implementable recommendations about diagnostic tests. Methods Using a critical analysis of the process we present the results of a case study using the Grading of Recommendations Applicability Development and Evaluation GRADE approach to develop a clinical practice guideline for the diagnosis of Cow Milk Allergy with the World Allergy Organization. Results To ensure that guideline panels can develop informed recommendations about diagnostic tests it appears that more emphasis needs to be placed on group processes including question formulation defining patient-important outcomes for diagnostic tests and summarizing evidence. Explicit consideration of concepts of diagnosis from evidence-based medicine such as pre-test probability and treatment threshold is required to facilitate the work of a .
