June 10, 2019
IPSWICH, Mass. — June 10, 2019 — On Tuesday, June 4, 2019, BMJ Open published an open access paper which defines the “certainty of net benefit” as a proposed method to report the impact of clinical recommendations. The report follows two years of development and deliberation within the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Working Group, an international collaborative that defines the most widely used method for expressing the certainty of evidence and strength of recommendations in clinical practice guidelines.
The paper’s lead author, Brian S. Alper, MD, MSPH, FAAFP, is the founder of DynaMed®, a point-of-care information resource for healthcare professionals that provides a synthesized and curated summary of the best current evidence and guidelines, and the Vice President of Innovations and Evidence-Based Medicine Development for EBSCO Information Services (EBSCO), a company that is developing a prominent role in solving some of the greatest challenges in healthcare decision-making.
Defining Certainty of Net Benefit: A GRADE Concept Paper describes in detail how a guideline developer or other information provider reporting evidence and guidance for healthcare can explicitly determine and express the certainty that the benefits outweigh the harms for a specific decision. EBSCO also provides a free online calculator to allow developers to determine the certainty of net benefit without requiring advanced statistical software.
Peter Oettgen, MD, FACC, FAHA, FACP, Editor-in-Chief for DynaMed, Cardiologist at Beth Israel Deaconess Medical Center, and one of the paper’s eleven co-authors, states, “Our goal is to encourage transparent communication between clinicians and their patients. Over time, we hope to see an increasing impact of more quantitative approaches of determining the risks and benefits of treatments and tests for patients as they start to have a better understanding of their medical options and receive concrete recommendations from their physicians.”
Alfonso Iorio, MD, PhD, FRCPC, Professor in the Department of Health Research Methods, Evidence and Impact at McMaster University, a member of the DynaMed Executive Board, and another co-author of the paper, states, “This paper is a milestone in our journey toward a transparent and reproducible act of balancing benefits and harms across multiple patient important outcomes. This could transform the way we issue clinical recommendations. A more robust and reproducible link between evidence and action.”
The certainty of net benefit concept today is described from the perspective of a guideline developer speaking to a healthcare professional. The EBSCO Health Innovations team is actively evaluating systems to apply and introduce the concept for personal use to identify health improvement opportunities and support individualized shared decision-making tools.
To view the paper, visit BMJ Open at: https://bmjopen.bmj.com/content/9/6/e027445.full.
About EBSCO’s Health Resources
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This paper is a milestone in our journey toward a transparent and reproducible act of balancing benefits and harms across multiple patient important outcomes. This could transform the way we issue clinical recommendations. A more robust and reproducible link between evidence and action.