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FORM: an Australian method for formulating and grading recommendations in evidence-based clinical guidelines.
Susan Hillier1, Karen Grimmer-Somers, Tracy Merlin
1international Centre for Allied Health Evidence, University of South Australia, Australia. susan.hillier@unisa.edu.au
BMC Medical Research Methodology
|March 2, 2011
Summary
Australian guideline developers now have a structured framework to grade recommendations. This methodology helps assess evidence quality, ensuring stronger, more reliable clinical practice guidelines.
Area of Science:
- Health Services Research
- Evidence-Based Medicine
- Clinical Practice Guidelines
Background:
- Clinical practice guidelines are crucial for evidence-based practice.
- Assessing complex evidence for guideline development has been challenging.
- Previous methods relied on individual study evidence levels, which is problematic.
Purpose of the Study:
- To produce and trial a methodology for Australian guideline developers.
- To assist in considering bodies of evidence and grading recommendations.
- To improve the formulation and grading of guideline recommendations.
Main Methods:
- A working group formed by the Australian National Health and Medical Research Council (NHMRC) developed a framework.
- The framework was informed by national and international expert consultation.
- Extensive piloting was conducted to refine the process.
Main Results:
- The FORM (Framework for Optimising Recommendations) framework was developed.
- It includes five components: evidence base, consistency, clinical impact, generalisability, and applicability.
- Guideline developers use this to structure decisions on recommendation strength and grading.
Conclusions:
- The FORM framework is widely adopted by Australian guideline developers.
- It is perceived as a logical and intuitive approach.
- The framework enhances the formulation and grading of recommendations in clinical practice guidelines.
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