Practice Guidelines Grading Systems

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.

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Key information

Conditions

Decision Making

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Escuela de Medicina y Biotecnologia del ITESM

Monterrey, Nuevo León, 64710, Mexico

About this study

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.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Pediatricians and residents in pediatrics

Exclusion criteria

Less than six months in clinical practice

Treatment and study plan

Graded Clinical Recommendation

Other

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

Primary outcomes

Change in Behavior in Physicians Attitude Towards a Decision to Give a Medication

Time frame: One day

A fictitious clinical case of a child with acute diarrhea was presented. The physician read the case and then answered the question "would you recommend racecadotril to this patient?" A zero to 10 visual-analog scale and a Likert scale were used to measure the decision of the physician related to the clinical case presented (from zero="definitely no" to 10="definitely yes"). Mean differences before-after and among groups were measured on the 10 centimeters scale.

Sponsors and collaborators

Lead sponsor

Instituto Tecnologico y de Estudios Superiores de Monterey

Other

Registry information

Official study title

Different Grading Systems to Grade Evidence and Recommendations in Clinical Practice Guidelines: Does it Influence the Clinicians´ Behavior?

Important dates

Study start: 2009
Primary completion: 2009
Study completion: 2009
First posted: Jul 16, 2009
Registry last updated: Jan 20, 2010

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Published trials that share one or more normalized conditions with this study.

Completed