PEN eNews 9(3) October 2019
October 2019 · Volume 9, Issue 3
How is PEN® “GRADE”ing the evidence for you?
Reposted from PEN eNews June 2016
PEN® has joined more than 100 organizations around in the world in using the GRADE system! To help dietitians understand the advantages of the GRADE system, how it will it impact what we see in PEN, and how as dietitians we can interpret and use this information in our practice, we presented The new face of PEN®: “GRADE”ing the evidence for you at the national Dietitians of Canada Annual Conference.
GRADE stands for Grading of Recommendations, Assessment, Development and Evaluation.
GRADE recommendations have two parts:
- Reviewing the evidence and indicating the quality of evidence, from high to very low.
- Our confidence in the actual results decreases with decreasing quality of evidence. For high quality evidence, we can be very confident in a result (called the effect estimate) or have little confidence in the effect estimate for very low quality evidence. We looked at examples of evidence tables to gain an appreciation of the factors considered in assessing the quality of evidence.
- Making a recommendation and indicating how strong a recommendation is. Developing a recommendation for a proposed course of action involves balancing benefits and harms, patients’ values and preferences, and the resources required to implement the intervention in question. We went through examples of strong and conditional recommendations, and the justification for these recommendations.
Reviewers play a key part in the PEN GRADE process. GRADE recommendations explicitly provide the key underlying information needed to act on a recommendation. Therefore reviewers’ feedback is necessary in several steps of the process from question identification to developing the recommendation. International review panel (IRP) members represent academic experts and practitioners with acknowledged expertise in topic areas. IRP members may be involved in:
- Reviewing the questions and identifying patient-important outcomes
- Reviewing the search strategy and literature retrieved
- Providing feedback on the evidence tables and recommendations.
One of the many benefits of moving to the PEN GRADE process includes helping readers understand how we arrived at a recommendation, thereby making recommendations more transparent. We are currently in a transition phase with GRADE implementation into the PEN system. Some questions that deal with diagnosis or prognosis, will use our existing PEN process. We will be focusing on using GRADE for intervention questions in PEN when we update and develop new content.
Dietitians, there are opportunities for you to be involved in the PEN GRADE process:
- Enhance your GRADE skill set by viewing the GRADE video.
- Mentor a student in the PEN GRADE approach using our tools and resources. You can view our PEN GRADE tools here.
By: Dawna Royall, MSc, RD
PEN® Senior Evidence Analyst
dawna.royall@dietitians.ca
Jayne Thirsk RD, PhD, FDC
Director of PEN® System
jayne.thirsk@dietitians.catools and resources
October 2019 ·
Volume 9
(3)
A Publication of the PEN System Global Partners,
a collaborative partnership between International Dietetic Associations.
Copyright Dietitians of Canada. All Rights Reserved.