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Comparing the USPSTF and GRADE Approaches to Recommendations

2009· letter· en· W2048776731 on OpenAlexaffabout
Gordon Guyatt

Bibliographic record

VenueAnnals of Internal Medicine · 2009
Typeletter
Languageen
FieldEconomics, Econometrics and Finance
TopicHealth Systems, Economic Evaluations, Quality of Life
Canadian institutionsMcMaster University
Fundersnot available
KeywordsMedicineVeterans AffairsTask forceFamily medicineGerontologyInternal medicinePolitical sciencePublic administration

Abstract

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Letters1 September 2009Comparing the USPSTF and GRADE Approaches to RecommendationsGordon H. Guyatt, MD, MSc, Mark Helfand, MD, MS, and Regina Kunz, MD, MSc(Epi)Gordon H. Guyatt, MD, MScFrom McMaster University Health Sciences Center, Hamilton, Ontario L8S 4L8, Canada; Portland Veterans Affairs Medical Center, Portland OR 97239; and University Hospital Basel, 4031 Basel, Switzerland., Mark Helfand, MD, MSFrom McMaster University Health Sciences Center, Hamilton, Ontario L8S 4L8, Canada; Portland Veterans Affairs Medical Center, Portland OR 97239; and University Hospital Basel, 4031 Basel, Switzerland., and Regina Kunz, MD, MSc(Epi)From McMaster University Health Sciences Center, Hamilton, Ontario L8S 4L8, Canada; Portland Veterans Affairs Medical Center, Portland OR 97239; and University Hospital Basel, 4031 Basel, Switzerland.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-151-5-200909010-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In their article on the "insufficient evidence" category of the U.S. Preventive Services Task Force (USPSTF) system (1), Petitti and colleagues make 3 potentially misleading statements about the Grading of Recommendations Assessment, Development and Evaluation (GRADE) (www.gradeworkinggroup.org) approach to rating quality of evidence and strength of recommendations (2). We would like to clarify the GRADE characteristics in question.First, Petitti and colleagues state that GRADE has no equivalent to the USPSTF "I statement." The I statement accompanies a USPSTF decision not to recommend either in favor or against an intervention because "the current evidence is insufficient to ...References1. Petitti DB, Teutsch SM, Barton MB, Sawaya GF, Ockene JK, DeWitt T; U.S. Preventive Services Task Force. Update on the methods of the U.S. Preventive Services Task Force: insufficient evidence. Ann Intern Med. 2009;150:199-205. [PMID: 19189910] LinkGoogle Scholar2. Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, et al; GRADE Working Group. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336:924-6. [PMID: 18436948] CrossrefMedlineGoogle Scholar3. Jaeschke R, Guyatt GH, Dellinger P, Schünemann H, Levy MM, Kunz R, et al; GRADE Working Group. Use of GRADE grid to reach decisions on clinical practice guidelines when consensus is elusive. BMJ. 2008;337:a744. [PMID: 18669566] CrossrefMedlineGoogle Scholar4. Guyatt GH, Oxman AD, Kunz R, Falck-Ytter Y, Vist GE, Liberati A, et al; GRADE Working Group. Going from evidence to recommendations. BMJ. 2008;336:1049-51. [PMID: 18467413] CrossrefMedlineGoogle Scholar5. Guyatt GH, Oxman AD, Kunz R, Jaeschke R, Helfand M, Liberati A, et al; GRADE Working Group. Incorporating considerations of resources use into grading recommendations. BMJ. 2008;336:1170-3. [PMID: 18497416] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From McMaster University Health Sciences Center, Hamilton, Ontario L8S 4L8, Canada; Portland Veterans Affairs Medical Center, Portland OR 97239; and University Hospital Basel, 4031 Basel, Switzerland.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoUpdate on the Methods of the U.S. Preventive Services Task Force: Insufficient Evidence Diana B. Petitti , Steven M. Teutsch , Mary B. Barton , George F. Sawaya , Judith K. Ockene , Thomas DeWitt , and Comparing the USPSTF and GRADE Approaches to Recommendations Diana B. Petitti , Steven M. Teutsch , Mary B. Barton , George F. Sawaya , Judith K. Ockene , and Thomas DeWitt Metrics Cited byEvidence-Based Medicine and State Health Care Coverage: The Washington Health Technology Assessment ProgramMyPreventiveCare: implementation and dissemination of an interactive preventive health record in three practice-based research networks serving disadvantaged patients—a randomized cluster trialA Framework for Crafting Clinical Practice Guidelines that are Relevant to the Care and Management of People with MultimorbidityUnderstanding Differences in the Guidelines for Colorectal Cancer Screening 1 September 2009Volume 151, Issue 5Page: 363KeywordsConflicts of interestGlobal health ePublished: 1 September 2009 Issue Published: 1 September 2009 Copyright & PermissionsCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.525
metaresearch head score (Gemma)0.868
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesMetaresearch
Consensus categoriesMetaresearch
DomainCandidate signal: Evaluation · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: none
GenreCandidate signal: Commentary · Consensus signal: none
Teacher disagreement score0.475
Threshold uncertainty score0.585

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.5250.868
Meta-epidemiology (narrow)0.0040.005
Meta-epidemiology (broad)0.0130.022
Bibliometrics0.0460.024
Science and technology studies0.0050.006
Scholarly communication0.0200.012
Open science0.0150.011
Research integrity0.0150.016
Insufficient payload (model declined to judge)0.0120.003

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.826
GPT teacher head0.488
Teacher spread0.338 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; the direct Gemma label and the distilled Codex classifier agree on what is shown here.

Study designNot applicable
DomainEvaluation
GenreCommentary

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

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Citations5
Published2009
Admission routes2
Has abstractyes

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