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J Korean Acad Fam Med. 2006 Nov;27(11):873-882. Korean. Original Article.
Kim SY , Kim NS , Lee HY , Bae SC , Kim CH , Kim JG , Uhm WS , Ji JD , Lee CH .
Department of Family Medicine, College of Medicine, Hallym University, Chuncheon, Korea. pclove@hallym.or.kr
Korea Institute for Health and Social Affairs, Korea.
Department of Preventive Medicine, College of Medicine, Korea University, Korea.
Division of Rheumatology, Hanyang University, Seoul, Korea.
Department of Family Medicine, Seoul Paik Hospital, Inje University, Korea.
Department of Orthopedic Surgery, Seoul Paik Hospital, Inje University, Busan, Korea.
Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Department of Internal Medicine, College of Medicine, Inje University, Busan, Korea.
Abstract

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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