Thursday, June 30, 2016

Proposed new evidence-based medicine pyramid

Systematic reviews and meta-analyses have been placed at the top of the evidence pyramid for several good reasons. They provide more trustworthy answers and more precise estimates with narrower confidence intervals that are were not selected based on expert opinion, but rather based on a systematic procedure. However, credible systematic review can summarize biased evidence and poorly done systematic reviews can summarize well done trials. This challenges the placement on top. In addition, GRADE tells us that our certainty in evidence should be driven by many factors other than study design. Therefore, we propose 2 modifications to the pyramid to resolve these 2 challenges.

Figure 1.

Legend: The proposed new evidence-based medicine pyramid. (A) The traditional pyramid. (B) Revising the pyramid: (1) lines separating the study designs become wavy (Grading of Recommendations Assessment, Development and Evaluation), (2) systematic reviews are ‘chopped off’ the pyramid. (C) The revised pyramid: systematic reviews are a lens through which evidence is viewed (and applied).

Tuesday, June 28, 2016

Scholarship Announcement for Next Guideline Development Workshop

Scholarship Opportunity Available for the Guideline Development Workshop

The U.S. GRADE Network in collaboration with Evidence Foundation is pleased to offer a scholarship program primarily for participants from North America for attendance of the Guideline Development Workshop in Orlando, FL. Recipients will be awarded a waived registration fee funded by the Evidence Foundation. The U.S. GRADE Network is now accepting applications (deadline: 8/31/2016).
Application: 500 words (or less) describing an innovation in guideline development, implementation, or teaching with the goal of reducing bias in health care recommendations. The innovation could be a future idea or proposal, or one that has already been implemented. The selected applicants will be given the opportunity to provide a 5-10 minute oral presentation to inform audience about their idea or project.
Candidates: New to GRADE without prior GRADE workshop attendance. Early involvement in guideline development (not based on age or experience). Access to a GRADE mentor following the workshop is a plus. The U.S. GRADE Network may be able to help identify a GRADE mentor.

Travel and lodging: Applicant’s institution pays for travel and lodging.

Application deadline: Please send application with a letter of support from your institution by August 31st, 2016 to