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Kvalitetsvurderings

- værktøjer

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GRADE

(Grading of Assessment, Development and Evaluation system)

Internationalt brugt systematisk og transperant system til at vurdere kvaliteten af evidens og give anbefalinger

◦ Formuleringen af fokuserede spørgsmål.

◦ Systematisk søgning efter litteratur

◦ Vurdering af kvaliteten af evidensen ud fra explicitte kriterier

◦ Udarbejdelse af anbefaling.

(3)

GRADE

(Grading of Assessment, Development and Evaluation system)

Internationalt brugt systematisk og transparant system til at vurdere kvaliteten af evidens og give anbefalinger

◦ Formuleringen af fokuserede spørgsmål.

◦ Systematisk søgning efter litteratur

Vurdering af kvaliteten af evidensen ud fra explicitte kriterier

◦ Udarbejdelse af anbefaling.

(4)

GRADE

(Grading of Assessment, Development and Evaluation system)

Hvis man anvender GRADE processen til kvalitetsvurdering af evidens, skal kvaliteten af en retningslinje eller et studie ALTID vurderes af to personer uafhængigt af hinanden.

Eventuelle uoverensstemmelser drøftes efterfølgende til man opnår konsensus.

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Kvalitetsvurderingsværktøjer

◦ AGREE II (Guidelines)

◦ AMSTAR 2 (systematiske oversigtsartikler)

◦ Cochrane Risk of Bias Tool (Randomiserede forsøg)

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AGREE II

Kvalitetsvurderingsværktøj til at vurdere kvaliteten og anvendeligheden af en guideline.

Værktøjet består af 26 spørgsmål og medfølgende vejledning til besvarelse af spørgsmålene.

Spørgsmålene er grupperet i domæner

(7)

AGREE II

◦ Domæne 1 Scope and Purpose

◦ Domæne 2 Stakeholder Involvement

◦ Domæne 3 Rigour of Development

◦ Domæne 4 Clarity of Presentation

◦ Domæne 5 Applicability

◦ Domæne 6 Editorial Independence

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AGREE II

◦ Domæne 1 Scope and Purpose

◦ Domæne 2 Stakeholder Involvement

Domæne 3 Rigour of Development – spørgsmål 8-14

◦ Domæne 4 Clarity of Presentation

◦ Domæne 5 Applicability

◦ Domæne 6 Editorial Independence

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AGREE II

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AMSTAR 2

(A MeaSurement Tool to Assess systematic Reviews)

Kvalitetsvurderingsværktøj til at vurdere kvaliteten og anvendeligheden af systematiske oversigtsartikler.

Værktøjet består af 16 spørgsmål og medfølgende vejledning til besvarelse af spørgsmålene.

AMSTAR 2 er ment som beslutningsstøtte til at vurdere kvaliteten af et studie.

Der er derved ikke fastsat et skæringspunkt for høj eller lav kvalitet.

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AMSTAR 2

o Item 1: Did the research questions and inclusion criteria for the review include the components of PICO?

o Item 2: Did the report of the review contain an explicit statement that the review methods were

established prior to conduct of the review and did the report justify any significant deviations from the protocol?

o Item 3: Did the review authors explain their selection of the study designs for inclusion in the review?

o Item 4: Did the review authors use a comprehensive literature search strategy?

o Item 5: Did the review authors perform study selection in duplicate?

o Item 6: Did the review authors perform data extraction in duplicate?

o Item 7: Did the review authors provide a list of excluded studies and justify the exclusions?

o Item 8: Did the review authors describe the included studies in adequate detail?

o Item 9: Did the review authors use a satisfactory technique for assessing the risk of bias (RoB) in individual studies that were included in the review?

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AMSTAR 2

oItem 10: Did the review authors report on the sources of funding for the studies included in the review?

oItem 11: If meta-analysis was justified did the review authors use appropriate methods for statistical combination of results?

oItem 12: If meta-analysis was performed did the review authors assess the potential impact of RoB in individual studies on the results of the meta-analysis or other evidence synthesis?

oItem 13: Did the review authors account for RoB in individual studies when interpreting/ discussing the results of the review?

oItem 14: Did the review authors provide a satisfactory explanation for, and discussion of, any heterogeneity observed in the results of the review?

oItem 15: If they performed quantitative synthesis did the review authors carry out an adequate investigation of publication bias (small study bias) and discuss its likely impact on the results of the review?

oItem 16: Did the review authors report any potential sources of conflict of interest, including any funding they received for conducting the review?

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AMSTAR

Tidligere version af AMSTAR

Brugt hidtil til udarbejdelse af KKR

Kan anvendes ved revisioner af tidligere KKR’er

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NKR AMSTAR

GRADE

Søgning

Systematiske reviews

Har anvendt GRADE

Høj kvalitet

Søgninger, estimater, evidensvurderinger og

GRADE tabeller

Lav kvalitet

Referencer

Har ikke anvendt GRADE

Højkvalitet

Søgninger, estimater og

evidens- vurderinger

Lavkvalitet

Referencer

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Cochrane Risk of Bias Tool

Kvalitetsvurderingsværktøj til at vurdere kvaliteten og anvendeligheden af Randomiserede forsøg (RCT).

Værktøjet består af en oversigt over de forskellige typer af bias opdelt i domæner og en vejledning i at vurdere dem.

RCT har som udgangspunkt ‘Høj kvalitet’. Derefter kan der nedgraderes til

‘Moderat kvalitet’, ‘Lav kvalitet’ eller ‘Meget lav kvalitet’ ved vurdering af 5 forskellige typer bias.

(18)
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Referencer

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