The Canadian Task Force on Preventive Health Care should not receive high ranking based on AGREEII or GRADE
Notice bibliographique
Résumé
I read with interest, the article by Ren et al. Global guidelines for breast cancer screening: A systematic review [[1]Ren W. Chen M. Qiao Y. Zhao F. Global guidelines for breast cancer screening: a systematic review.Breast. 2022; 64: 85-99Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar].It was a disappointment that the breast cancer screening guideline from the Canadian Task Force on Preventive Health Care (CTF) was ranked highly. Although ranking was according to 6 domains using AGREEII criteria, the authors would not be aware from just reading the guideline paper, that CTF did not follow the spirit/intent of AGREE [[2]The appraisal of guidelines for research and evaluation (AGREE) II instrument: introduction, user's manual and AGREE II instrument. https://www.cmaj.ca/content/cmaj/suppl/2010/07/05/cmaj.090449.DC1/advance-brouwers-appendix.pdf.Google Scholar], specifically with respect to Stakeholder Involvement or Rigour of Development and did not follow the GRADE system [[3]Guyatt G.H. Oxman A.D. Vist G.E. Kunz R. Falck-Ytter Y. Alonso-Coello P. et al.GRADE: an emerging consensus on rating quality of evidence and strength of recommendations.BMJ. 2008; 336: 924https://doi.org/10.1136/bmj.39489.470347.ADCrossref PubMed Google Scholar] for determining which evidence to consider.AGREEII states that the "guideline development group includes individuals from all relevant professional groups." There were no experts in breast cancer on the CTF panel. They further state that "views and preferences of the target population (patients, public, etc.) have been sought." The CTF ignored input from advocates for breast density notification. AGREE states, "The guideline has been externally reviewed by experts prior to its publication." Indeed, many experts did review and criticize the guideline, but their input was ignored by CTF.GRADE states that although randomized clinical trials (RCTs) generally produce more reliable evidence than observational studies, they also specify that flawed RCTs may be downgraded, and observational studies may be upgraded when they are carefully performed and show large magnitude benefits. CTF included the Canadian National Breast Screening Studies (CNBSS) even though their results suggested compromised randomization [[4]Seely J.M. Eby P.R. Gordon P.B. Appavoo S. Yaffe M.J. Errors in conduct of the CNBSS trials of breast cancer screening observed by research personnel.J Breast Imag. March/April 2022; 4: 135-143https://doi.org/10.1093/jbi/wbac009Crossref Scopus (10) Google Scholar] which has now been confirmed, and excluded the Pan-Canadian observational study [[5]Coldman A. Phillips N. Wilson C. Decker K. Chiarelli A.M. Brisson J. Zhang B. Payne J. Doyle G. Ahmad R. Pan-Canadian study of mammography screening and mortality from breast cancer.J Natl Cancer Inst: J Natl Cancer Inst. November 2014; 106: dju261https://doi.org/10.1093/jnci/dju261Crossref PubMed Scopus (162) Google Scholar], which showed 40% mortality reduction. I read with interest, the article by Ren et al. Global guidelines for breast cancer screening: A systematic review [[1]Ren W. Chen M. Qiao Y. Zhao F. Global guidelines for breast cancer screening: a systematic review.Breast. 2022; 64: 85-99Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar]. It was a disappointment that the breast cancer screening guideline from the Canadian Task Force on Preventive Health Care (CTF) was ranked highly. Although ranking was according to 6 domains using AGREEII criteria, the authors would not be aware from just reading the guideline paper, that CTF did not follow the spirit/intent of AGREE [[2]The appraisal of guidelines for research and evaluation (AGREE) II instrument: introduction, user's manual and AGREE II instrument. https://www.cmaj.ca/content/cmaj/suppl/2010/07/05/cmaj.090449.DC1/advance-brouwers-appendix.pdf.Google Scholar], specifically with respect to Stakeholder Involvement or Rigour of Development and did not follow the GRADE system [[3]Guyatt G.H. Oxman A.D. Vist G.E. Kunz R. Falck-Ytter Y. Alonso-Coello P. et al.GRADE: an emerging consensus on rating quality of evidence and strength of recommendations.BMJ. 2008; 336: 924https://doi.org/10.1136/bmj.39489.470347.ADCrossref PubMed Google Scholar] for determining which evidence to consider. AGREEII states that the "guideline development group includes individuals from all relevant professional groups." There were no experts in breast cancer on the CTF panel. They further state that "views and preferences of the target population (patients, public, etc.) have been sought." The CTF ignored input from advocates for breast density notification. AGREE states, "The guideline has been externally reviewed by experts prior to its publication." Indeed, many experts did review and criticize the guideline, but their input was ignored by CTF. GRADE states that although randomized clinical trials (RCTs) generally produce more reliable evidence than observational studies, they also specify that flawed RCTs may be downgraded, and observational studies may be upgraded when they are carefully performed and show large magnitude benefits. CTF included the Canadian National Breast Screening Studies (CNBSS) even though their results suggested compromised randomization [[4]Seely J.M. Eby P.R. Gordon P.B. Appavoo S. Yaffe M.J. Errors in conduct of the CNBSS trials of breast cancer screening observed by research personnel.J Breast Imag. March/April 2022; 4: 135-143https://doi.org/10.1093/jbi/wbac009Crossref Scopus (10) Google Scholar] which has now been confirmed, and excluded the Pan-Canadian observational study [[5]Coldman A. Phillips N. Wilson C. Decker K. Chiarelli A.M. Brisson J. Zhang B. Payne J. Doyle G. Ahmad R. Pan-Canadian study of mammography screening and mortality from breast cancer.J Natl Cancer Inst: J Natl Cancer Inst. November 2014; 106: dju261https://doi.org/10.1093/jnci/dju261Crossref PubMed Scopus (162) Google Scholar], which showed 40% mortality reduction.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,224 | 0,679 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,003 |
| Méta-épidémiologie (sens large) | 0,010 | 0,010 |
| Bibliométrie | 0,021 | 0,023 |
| Études des sciences et des technologies | 0,010 | 0,007 |
| Communication savante | 0,019 | 0,010 |
| Science ouverte | 0,010 | 0,008 |
| Intégrité de la recherche | 0,017 | 0,020 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,020 | 0,012 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; l’étiquette directe de Gemma et le classifieur distillé Codex s’accordent sur ce qui est montré ici.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».