In late October, the U.S. Grade Network held its thirteenth GRADE Guideline Development Workshop. Like any of the twelve workshops before it, there was much learning, discussion, and networking to be shared. However, unlike any workshop in the past, it was fully online.
Among the 45 attendees who participated in offices and living rooms from Brazil to Cyprus were four participants who attended the workshop free of charge as recipients of the Evidence Foundation scholarship. During a virtual Evening with the Fall 2020 Evidence Foundation Scholars, these four bright minds presented briefly on a proposal or current project designed to reduce bias in healthcare.
Dr. Stavros Antoniou, Chair of the European Association for Endoscopic Surgery Guidelines Subcommittee, discussed the tripartite Guideline Assessment Project (GAP) aimed at developing an extension of the AGREE II tool for surgical guidelines. In an exploratory analysis published earlier in 2018 (GAP I), Antoniou and colleagues assessed 67 surgical guidelines and reported that development of more than one guideline per year, the presence of a guideline committee, and the use of GRADE was associated with higher scores in AGREE II. Second, the group explored the reliability, internal consistency, and unidimensionality of the AGREE II tool when applied to surgical guidelines (GAP II). The group is now in the process of using the Delphi process to identify and finalize items for the surgical extension based on stakeholder input, pilot-testing the instrument, and assessing its validity (GAP III). Of the workshop. Dr. Antoniou noted, "participating in the GRADE Guideline Workshop as a scholar was an inspirational experience. It was fascinating to be trained by world-renowned experts, who have embraced us with true interest and conveyed their passion with quality in guideline development."
Jung Min Han, PharmD, MS, manages the development of guidelines for the American Academy of Dermatology. Her presentation reviewed her current project to update the organization's 2016 guidelines on the management of acne vulgaris using the GRADE framework. Ms. Han discussed the plan to organize two working groups, one to review and update the nine clinical questions from the previous guidelines, and the other to add additional new questions as needed. An updated search would then be run for the first set of questions to identify any newly published evidence since the original guidelines were developed; simultaneously, a novel systematic search would be conducted for the second group of questions. New recommendations would then be drafted following the GRADE methodology. Ms. Han stated, "The GRADE Workshop has trained me to confidently use GRADE in different scenarios where head-to-head data from randomized controlled trials are not available. The workshop was very well-structured with a concrete theme and a mix of lectures, small and large group discussions, meet the experts Q&A sessions, and real-world examples that challenged trainees in many ways."
Dr. Georgios Schoretsanitis of Zucker Hillside Hospital in Glen Oaks, New York presented on his work developing guidelines for therapeutic drug monitoring to optimize and tailor treatment for psychotherapeutic medications. Beginning in 2017, a series of recommendations for reference ranges for two commonly prescribed antipsychotic medications was developed, followed this year by an international joint consensus statement on blood levels to optimize antipsychotic treatment in clinical practice. "For long I have been interested in conducting systematic reviews and meta-analyses," said Dr. Schoretsanitis. "Attending the GRADE Guideline Workshop organized by the US GRADE Network gave me exactly what I was looking for: a unique chance to essentially deepen my knowledge on major methodological aspects during stimulating lectures by experts that have set the tone in the field. It was an intense experience far beyond acquiring knowledge, which I highly suggest to every methodologist."
Dr. Zeinab Hosseini, a Saskatchewan Health Research post-doctoral fellow at the University of Saskatchewan, discussed her work examining the impact of exercise interventions on osteoporosis. Because gender and sex affect the prognosis and management of the disease, guidelines that consider these differences are needed, she said. As part of her research under the advisement of Dr. Phil Chilibeck, she hopes to contribute further understanding in the field related to gender- and sex-specific considerations for exercise recommendations in patients with osteoporosis, and to help inform future guideline recommendations on this topic. "The US GRADE Network Workshop was an amazing opportunity for me as a post-doctoral fellow in health proving insight on how to think as a health researcher from early stages of research up to knowledge translation and dissemination and how to provide evidence-based recommendations to inform the public considering situations where the literature is scarce," said Dr. Hosseini. "There are top women and men scientists on the training panel who respond to questions using their experiences as member on different panels, which I think is unique."
|The USGN facilitators pose for a virtual group photo with the four fall 2020 Evidence Foundation scholars. Click to enlarge.|
The Evidence Foundation thanks all four scholars for attending and contributing their engagement and expertise to our 2020 fall workshop.
If interested in applying for a scholarship to future GRADE workshops, more details can be found here: https://evidencefoundation.org/scholarships.html. Please note the deadline for applications to our next workshop in Chicago, Illinois will be February 28, 2021.