Practice Guidelines Grading Systems

NCT ID: NCT00940290

Last Updated: 2010-01-20

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

216 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-08-31

Study Completion Date

2009-11-30

Brief Summary

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Clinical practice guidelines (CPG) are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances. They are developed to give a recommendation based on the best evidence available. Through a randomized trial, the investigators intend to provide information about which of the four grading systems most used today to grade evidence and recommendations in CPGs, could change physician´s behavior towards a common clinical situation in daily practice.

Detailed Description

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Clinical practice guidelines (CPG) are used by professional and consumer organizations who are demanding more rigorous processes to ensure that health decisions are well informed by the best available research evidence. More than 60 different grading systems are used today to grade evidence and recommendations in CPGs. The investigators aimed to provide information about which of the four most common grading systems used today (GRADE, SIGN, NICE and CEBM-Oxford) could change physician´s behavior when reading a clinical recommendation in a CPG. The investigators will randomize 216 pediatricians and pediatricians in training into four groups (one for each grading system) to read a clinical case and to make a decision before reading the CPG statement graded with any of the four grading systems. After that they will re-consider their answer and post a new one based on the graded recommendation. The investigators will measure change in their decision and among groups.

Conditions

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Decision Making

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Blinding Strategy

NONE

Study Groups

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GRADE system

A clinical recommendation built and graded with the GRADE working group system

Group Type OTHER

Graded Clinical Recommendation

Intervention Type OTHER

Graded recommendation in reference to a clinical condition written as it would be in a clinical practice guideline

SIGN grading system

A clinical recommendation built and graded with the Scottish Intercollegiate Guidelines Network system

Group Type OTHER

Graded Clinical Recommendation

Intervention Type OTHER

Graded recommendation in reference to a clinical condition written as it would be in a clinical practice guideline

NICE grading system

A clinical recommendation built and graded with National Institute of Clinical Excellence grading system

Group Type OTHER

Graded Clinical Recommendation

Intervention Type OTHER

Graded recommendation in reference to a clinical condition written as it would be in a clinical practice guideline

CEBM-Oxford

A clinical recommendation built and graded with the Centre for Evidence-Based Medicine grading system

Group Type OTHER

Graded Clinical Recommendation

Intervention Type OTHER

Graded recommendation in reference to a clinical condition written as it would be in a clinical practice guideline

Interventions

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Graded Clinical Recommendation

Graded recommendation in reference to a clinical condition written as it would be in a clinical practice guideline

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Pediatricians and residents in pediatrics

Exclusion Criteria

* Less than six months in clinical practice
Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Instituto Tecnologico y de Estudios Superiores de Monterey

OTHER

Sponsor Role lead

Responsible Party

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Instituto Tecnologico y de Estudios Superiores de Monterrey

Principal Investigators

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Carlos A Cuello-Garcia, MD

Role: PRINCIPAL_INVESTIGATOR

Instituto Tecnologico y de Estudios Superiores de Monterey

Locations

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Escuela de Medicina y Biotecnologia del ITESM

Monterrey, Nuevo León, Mexico

Site Status

Countries

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Mexico

References

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Cuello Garcia CA, Pacheco Alvarado KP, Perez Gaxiola G. Grading recommendations in clinical practice guidelines: randomised experimental evaluation of four different systems. Arch Dis Child. 2011 Aug;96(8):723-8. doi: 10.1136/adc.2010.199307. Epub 2011 May 19.

Reference Type DERIVED
PMID: 21596725 (View on PubMed)

Other Identifiers

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CMBE-ITESM-1

Identifier Type: -

Identifier Source: org_study_id

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