Evidence to Decision frameworks (EtDs) for decision makers
Background
Between 2011 and 2015, a project group, including researchers from Cochrane Norway, took part in the DECIDE project, which was co-funded by the European Commission under the Seventh Framework Programme. The project objective was "to improve the dissemination of evidence-based recommendations by building on the work of the GRADE Working Group to develop and evaluate methods that address the targeted dissemination of guidelines". This work led to the development of the GRADE Evidence-to-Decision frameworks.
What are Evidence to Decision frameworks (EtD)?
The purpose of an EtD framework is to help groups of people making healthcare recommendations or decisions move from evidence to decisions. EtD frameworks can:
- Inform panel members’ judgements about the pros and cons of each intervention that is considered
- Ensure the important factors that determine a decision (criteria) are considered
- Provide a concise summary of the best available research evidence to inform judgements about each criterion
- Help structure discussion and identify reasons for disagreements
- Make the basis for decisions transparent to guideline users or those affected by a policy decision
The EtD framework is easily adaptable for use in making clinical recommendations, coverage-decisions, or health system and public health recommendations and decisions.
Relevant publications involving staff at Cochrane Norway
- Treweek S., Oxman A.D., Alderson P., Bossuyt P.M., Brandt L., Davoli M., Flottorp S., Harbour R., Hill S., Liberati A. Lijra H., Schünemann H., Rosenbaum S., Thornton., Vandvik P.O., Alonso-Coello P., DECIDE Consortium. Developing and evaluating communication strategies to support informed decisions and practice based on evidence (DECIDE): protocol and preliminary results. Implementation Science 2013, 8:6.
- Alonso-Coello P, Schünemann HJ, Moberg J, Brignardello-Petersen R, Akl EA, Davoli M, Treweek S, Mustafa RA, Rada G, Rosenbaum S, Morelli A, Guyatt GH, Oxman AD; GRADE Working Group. GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 1: Introduction. BMJ. 2016 Jun 28;353:i2016. doi: 10.1136/bmj.i2016. PMID: 27353417.
- Moberg, J., Oxman, A.D., Rosenbaum, S., Schünemann H.J., Guyatt G., Flottorp S., Glenton C., Lewin S., Morelli A., Rada G., Alonso-Coello P, for the GRADE Working Group. The GRADE Evidence to Decision (EtD) framework for health system and public health decisions. Health Res Policy Sys 16, 45 (2018). https://doi.org/10.1186/s12961-018-0320-2