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Evaluation of the group decision making process of clinical guideline panels
Investigator (PI): Djulbegovic, Benjamin
Performing Organization (PO): (Current): City of Hope, Beckman Research Institute / (626) 256-4673
(Past): University of South Florida, Morsani College of Medicine, Department of Internal Medicine / (813) 974-6849
Supporting Agency (SA): Agency for Healthcare Research and Quality (AHRQ)
Initial Year: 2016
Final Year: 2021
Record Source/Award ID: RePorter/R01HS024917
Funding: 2016 Award Amount: $391,054
2017 Award Amount: $384,501
2018 Award Amount: $373,816
2019 Award Amount: $362,977
2020 Award Amount: $358,118
Award Type: Grant
Award Information: Reports resulting from this project
Abstract: Clinical practice guidelines (CPGs) are essential to improve health care delivery and patient outcomes, and are increasingly tied to reimbursement. To date, the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system has emerged as the leading prescriptive system for developing CPGs and is widely used both in the US and worldwide. Development of CPGs is the product of group judgment. Surprisingly, and despite the importance of group judgments for issuing guidelines, little work has been done to analyze how the CPG panels make their judgments within or outside the GRADE system. Because the GRADE is considered the best prescriptive system for development of CPGs, we hypothesize that the panels' group judgments will accurately reflect a relationship between GRADE key criteria ("cues") and the strength of recommendations, modified to some extent by other factors known to affect people's decision making. To address our hypothesis, we will assess the impact of GRADE factors on group judgment process vs. individual panel members according to the lens model (SA#1). We will supplement this analysis with the qualitative evaluation of additional constructs that are not formally included in the GRADE system (SA1b). In SA#2, we will address the role of contextual factors and other factors that may affect the consistency of CPG judgments (e.g., more socially relevant topics, greater diversity of CPG panels, and/or panels with conflict of interest will generate greater discrepancy between individual and group judgments). In total, we will study 14 CPG panels, which will generate about 2,000 practice recommendations. To meet our short-term objectives, we propose an innovative study aiming to explain CPG panel judgments using a theoretically sound lens model. Our long-term objective is to improve CPG panel judgments' accuracy. By improving understanding of CPG judgment processes, the proposed study will exert a sustained impact on the way we develop CPGs. Both public health and health care financing depend on reliable, trustworthy CPGs. Therefore, it is of utmost importance to understand group judgment processes that are the foundations of the CPG development.
MeSH Terms:
  • * Decision Making
  • Evidence-Based Medicine
  • Global Health
  • Group Processes
  • * Guidelines as Topic
  • Health Services Research
  • Humans
  • Outcome Assessment, Health Care
  • Program Evaluation
  • United States
Country: United States || United States
State: California || Florida
Zip Code: 33612 / 91010
UI: 20171248
Project Status: Ongoing
Related Records: PA-20-070: Development of evidence-based decision support for the management of COVID-19
Record History: ('2019: PO changed',)