J Korean Acad Fam Med.
2006 Nov;27(11):873-882.
Evaluation of Consistency, Generalizability, Applicability of Recommendations about Pharmacological Treatment of Osterarthritis using RAND Method
- Affiliations
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- 1Department of Family Medicine, College of Medicine, Hallym University, Chuncheon, Korea. pclove@hallym.or.kr
- 2Korea Institute for Health and Social Affairs, Korea.
- 3Department of Preventive Medicine, College of Medicine, Korea University, Korea.
- 4Division of Rheumatology, Hanyang University, Seoul, Korea.
- 5Department of Family Medicine, Seoul Paik Hospital, Inje University, Korea.
- 6Department of Orthopedic Surgery, Seoul Paik Hospital, Inje University, Busan, Korea.
- 7Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
- 8Department of Internal Medicine, College of Medicine, Inje University, Busan, Korea.
Abstract
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BACKGROUND: When research based evidence is not sufficient, clinical practice guidelines can be based on opinions. In such situations, formal consensus development methods, often based on the modified nominal group techniques are widely used. It can be used to evaluate consistency, generalizability, applicability of recommendation when evidence comes from other countries.
METHODS
To develop evidence based guidelines for osterarthritis pharmacotherapy, a consensus expert panel consisting of internists, family physicians, methodologists, and orthopedic surgeons were convened. After an extensive structured literature searching and evaluation, evidence statements for key question were developed. Rating methods for consistency, generalizability, applicability of statement were adopted from those jointly developed by Rand and the University of California, Los Angeles.
RESULTS
We developed 27 evidence statements in 17 question domains. Among 72 rating items, 62 items reached agreement. Among 15 recommendations, 10 recommendation grading were A, 2 were B, and 3 were C.
CONCLUSION
When research based evidence is not sufficient, clinical practice guidelines can be based on formal consensus of experts, especially modified nominal group techniques. It can be used to evaluate consistency, generalizability, applicability of recommendation when evidence comes from other countries.
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