GRADE: assessing the quality of evidence for diagnostic recommendations.


I like simple solutions: paper notebooks that require no batteries or software, pencils that write upside down, and bicycles, which keep me and the planet fit. In this issue, we have a couple of low-technology suggestions for the problem of getting evidence into practice. First is a Notebook on the EBM step that comes after the clinical bottom line—what else do we need to do to implement the evidence? We may need new equipment, or more information, or a change to a clinical form, or a reminder set up, etc. These ‘‘Next Action’’ steps take only a few more minutes but add considerable leverage for teams trying to improve their care of patients. A further step again is the need for good communication of evidence to patients. There have been many sophisticated decision tools developed, but a neat and simple paper solution is to keep blank sheets of ‘‘100 faces’’ nearby to aid in walking patients through their individual risks and benefits. (The Word template is downloadable from the Evidence-Based Medicine journal website.) In September, we held the 14th Teaching EBM workshop in Oxford. I am always humbled by how much more there is to learn about teaching and about EBM. Both are vast lakes from which we can drink a little or dive deep. Given the limited number of teachers and teaching resources for EBM, Dan Mayer’s demonstration of Team-Based Learning was helpful. The technique allows for good small-group learning but with multiple groups directed by a single facilitator. For those without enough tutors to go around, it is a marvelous learning method. Online learning was another theme of the week, with clear growth in this area. A few online resources to look at include, which is the wiki that the librarians who help in each group have put together as a guide to EBM searching and the workshop, and, which has Rod Jackson’s GATE tools downloadable as spreadsheets.

DOI: 10.1136/ebm.13.6.162-a
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@article{Schnemann2008GRADEAT, title={GRADE: assessing the quality of evidence for diagnostic recommendations.}, author={Holger J. Sch{\"{u}nemann and Andrew D. Oxman and Jan L. Brożek and Paul Phillip Glasziou and Patrick M. M. Bossuyt and Stephanie M. Chang and Paola Muti and Roman C Jaeschke and Gordon H. Guyatt}, journal={Evidence-based medicine}, year={2008}, volume={13 6}, pages={162-3} }