Credible knowledge: a pilot evaluation of a modified GRADE method using parent-implemented interventions for children...

Area of Science:

• Child and Youth Mental Health
• Evidence-Based Practice
• Clinical Decision-Making

Background:

• Child and Youth Mental Health (CYMH) decision-making requires recommendations based on credible knowledge from scientific and practice-based evidence.
• Current CYMH recommendation methods often lack objective ways to combine these two evidence sources.
• A modified Grading Recommendations Assessment, Development and Evaluation (GRADE) approach was pilot-tested for CYMH.

Purpose of the Study:

• To pilot-test a modified GRADE approach for developing recommendations in CYMH.
• To assess the effectiveness and practicality of combining scientific and practice-based evidence.
• To address a specific CYMH question regarding parent-implemented early intervention for autistic children.

Main Methods:

• Utilized a modified GRADE methodology involving a panel of experts.
• Assessed the quality of scientific evidence and practice-based experience.
• Derived specific recommendations based on the net benefits and harms of interventions.

Main Results:

• Early, parent-implemented interventions for autism showed positive effects outweighing undesirable ones.
• Evidence heterogeneity necessitated specific recommendations for particular interventions.
• Recommendations focused on whether intervention benefits exceeded harms.

Conclusions:

• The modified GRADE method is a potentially effective and practical approach for CYMH recommendations.
• Strengths include separating evidence quality and recommendation strength, transparency, and objectivity.
• The method offers a more timely, explicit, and simple process for combining evidence and clinical experience.