None / Clinicians in general value the use of the best evidence in decision-making and consider
that can improve patient care. However, a successful evidence based practice is hard to
achieve in real life. In recent years, with the consolidation of the Grading of
Recommendations Assessment, Development and Evaluation (GRADE) approach, the
development of improved standards to judge the trustworthiness of guideline
recommendations and the adoption of more strict policies to limit the influence of
conflict of interests, trustworthy guidelines have become an attractive alternative for an
evidence-based clinical practice.
In this thesis we offer an explicit and easy-to-use guidance to clinicians regarding how to
use guideline recommendations in the context of a real life practice. We also provide an
in-depth explanation of the judgments involved in determining the direction and strength
of recommendations. Finally, we expand the knowledge about how to manage conflict of
interests in guideline developers. Through two studies evaluating the conflict of interest
policy implemented at the American College of Chest Physicians 9th edition of the
Antithrombotic Guidelines, we show what aspects of the policy were successful and what
aspects need to be reformulated. / Thesis / Doctor of Philosophy (PhD) / None
| Identifer | oai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/16000 |
| Date | 11 1900 |
| Creators | Neumann, Ignacio |
| Contributors | Guyatt, Gordon, Schünemann, Holger, Akl, Elie, Health Research Methodology |
| Source Sets | McMaster University |
| Language | English |
| Detected Language | English |
| Type | Thesis |
Page generated in 0.0025 seconds