Development of the European Commission Initiative on Breast Cancer Guidelines
Bibliographic record
Abstract
Letters7 January 2020Development of the European Commission Initiative on Breast Cancer GuidelinesHolger J. Schünemann, MD, PhD, MSc, Pablo Alonso-Coello, MD, PhD, Axel Gräwingholt, MD, Cecily Quinn, MD, Markus Follmann, MD, MPH, MSc, Miranda Langendam, PhD, and Zuleika Saz-Parkinson, PhDHolger J. Schünemann, MD, PhD, MScMcMaster University Health Sciences Centre, Hamilton, Ontario, Canada (H.J.S.), Pablo Alonso-Coello, MD, PhDIberoamerican Cochrane Centre, Barcelona, Spain (P.A.), Axel Gräwingholt, MDRadiologie am Theater, Paderborn, Germany (A.G.), Cecily Quinn, MDSt. Vincent's University Hospital, Dublin, Ireland (C.Q.), Markus Follmann, MD, MPH, MScGerman Cancer Society, Berlin, Germany (M.F.), Miranda Langendam, PhDUniversity of Amsterdam Medical Centre, Amsterdam, the Netherlands (M.L.), and Zuleika Saz-Parkinson, PhDEuropean Commission, Joint Research Centre, Ispra, Italy (Z.S.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0621 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Watine incorrectly asserts that the European Guidelines for Breast Cancer Screening and Diagnosis (known as the European Breast Guidelines) do not adhere to the GRADE working group's definitions of strong and conditional recommendations. However, the statements that he cites refer to GRADE's "interpretations" of recommendations, not their "definitions." The GRADE approach states that the strength of a recommendation "is defined as the extent to which one can be confident that the desirable consequences of an intervention outweigh its undesirable consequences" and has "specific implications for patients, the public, clinicians, and policy makers" (1).The European Breast Guidelines ...References1. Andrews J, Guyatt G, Oxman AD, et al; GRADE guidelines: 14.. Going from evidence to recommendations: the significance and presentation of recommendations. J Clin Epidemiol. 2013;66:719-25. [PMID: 23312392] doi:10.1016/j.jclinepi.2012.03.013 CrossrefMedlineGoogle Scholar2. Alonso-Coello P, Schünemann HJ, Moberg J, et al; GRADE Working Group.. GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 1: Introduction. BMJ. 2016;353:i2016. [PMID: 27353417] doi:10.1136/bmj.i2016 CrossrefMedlineGoogle Scholar3. Alonso-Coello P, Oxman AD, Moberg J, et al; GRADE Working Group.. GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 2: Clinical practice guidelines. BMJ. 2016;353:i2089. [PMID: 27365494] doi:10.1136/bmj.i2089 CrossrefMedlineGoogle Scholar4. Schünemann HJ, Lerda D, Quinn C, et al. Breast cancer screening and diagnosis: a synopsis of the European Breast Guidelines. Ann Intern Med. 2020;172:46-56. doi:10.7326/M19-2125 LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: McMaster University Health Sciences Centre, Hamilton, Ontario, Canada (H.J.S.)Iberoamerican Cochrane Centre, Barcelona, Spain (P.A.)Radiologie am Theater, Paderborn, Germany (A.G.)St. Vincent's University Hospital, Dublin, Ireland (C.Q.)German Cancer Society, Berlin, Germany (M.F.)University of Amsterdam Medical Centre, Amsterdam, the Netherlands (M.L.)European Commission, Joint Research Centre, Ispra, Italy (Z.S.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-3445. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoMethods for Development of the European Commission Initiative on Breast Cancer Guidelines Holger J. Schünemann , Donata Lerda , Nadya Dimitrova , Pablo Alonso-Coello , Axel Gräwingholt , Cecily Quinn , Markus Follmann , Robert Mansel , Francesco Sardanelli , Paolo Giorgi Rossi , Annette Lebeau , Lennarth Nyström , Mireille Broeders , Lydia Ioannidou-Mouzaka , Stephen W. Duffy , Bettina Borisch , Patricia Fitzpatrick , Solveig Hofvind , Xavier Castells , Livia Giordano , Sue Warman , Zuleika Saz-Parkinson , and Development of the European Commission Initiative on Breast Cancer Guidelines Joseph Watine Metrics Cited byBringing two worlds closer together: a critical analysis of an integrated approach to guideline development and quality assurance schemes 7 January 2020Volume 172, Issue 1Page: 72-73KeywordsAge groupsBehaviorBreast cancerBreast cancer screeningDecision makingDisclosureGrading of Recommendations Assessment Development and EvaluationMammographyPrevention, policy, and public healthPublic policy ePublished: 7 January 2020 Issue Published: 7 January 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot 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.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.050 | 0.308 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.004 | 0.003 |
| Bibliometrics | 0.007 | 0.004 |
| Science and technology studies | 0.002 | 0.004 |
| Scholarly communication | 0.010 | 0.008 |
| Open science | 0.010 | 0.007 |
| Research integrity | 0.030 | 0.032 |
| Insufficient payload (model declined to judge) | 0.018 | 0.017 |
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.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
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".