Report in English with a Dutch summary (KCE reports 45A)

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186 Screening for Colorectal Cancer: Appendices KCE reports vol.45 RATING SCHEMES FOR THE STRENGTH OF EVIDENCE & RECOMMENDATIONS Centre of Evidence Based Medicine (CEBM - UK) Grade of recommendation A B Very detailed levels of evidence and grades of recommendation, adapted for reviewing different kinds of studies, were established by the NHS R&D Centre of Evidence Based Medicine596 (latest version, March 2002). In depth discussion of these various criteria remains outside the scope of this report. Level of Evidence 1a 1b 1c 2a 2b Therapy: whether a treatment is efficacious/ effective/harmful SR (with homogeneity*) of RCTs Individual RCT (with narrow Confidence Interval ) Therapy: whether a drug is superior to another drug in its same class SR (with homogeneity**) of head-to-head RCTs Within a head-to-head RCT with clinically important outcomes Prognosis Diagnosis SR (with homogeneity*) of inception cohort studies; CDR validated in different populations Individual inception cohort study with > 80% follow-up; CDR validated in a single population SR (with homogeneity*) of Level 1 diagnostic studies; CDR with 1b studies from different clinical centres Validating** cohort study with good reference standards; or CDR tested within one clinical centre All or none§ All or none case-series Absolute SpPins and SnNouts SR (with homogeneity*) of cohort studies Individual cohort study (including low quality RCT; e.g., 2 diagnostic studies Exploratory** cohort study with good reference standards; Differential diagnosis/symptom prevalence study SR (with homogeneity*) of prospective cohort studies Prospective cohort study with good follow-up**** Economic and decision analysis SR (with homogeneity*) of Level 1 economic studies Analysis based on clinically sensible costs or alternatives; systematic review(s) of the evidence; and including multi-way sensitivity analyses All or none case-series Absolute better-value or worse-value analyses SR (with homogeneity*) of 2b and better studies Retrospective cohort study, or poor follow-up SR (with homogeneity*) of Level >2 economic studies Analysis based on clinically sensible costs or alternatives; limited
KCE reports vol.45 Screening for Colorectal Cancer: Appendices 187 2c 3a 3b C 4 D 5 up) patients with clinically important or validated surrogate outcomes patients in an RCT; Derivation of CDR or validated on splitsample§§§ only CDR after derivation, or validated only on split-sample§§§ or databases review(s) of the evidence, or single studies; and including multi-way sensitivity analyses "Outcomes" Research; Ecological studies "Outcomes" Research Ecological studies Audit or outcomes research SR (with homogeneity*) Across subgroup analyses SR (with SR (with homogeneity*) of SR (with of case-control studies from RCTs of different homogeneity*) of 3b 3b and better studies homogeneity*) of 3b drugs v. placebo in similar or different patients, with clinically important or validated surrogate outcome and better studies and better studies Individual Case-Control Across RCTs of different Non-consecutive Non-consecutive Analysis based on Study drugs v. placebo in study; or without cohort study, or very limited alternatives or similar or different consistently applied limited population costs, poor quality patients but with reference standards estimates of data, but unvalidated surrogate including sensitivity outcomes analyses incorporating clinically sensible variations. Case-series (and poor Between non- Case-series (and poor Case-control study, Case-series or superseded Analysis with no quality cohort and randomised studies quality prognostic poor or non- reference standards sensitivity analysis case-control studies§§ ) (observational studies studies ***) independent reference and administrative database research) with clinically important outcomes standard Expert opinion without Expert opinion without Expert opinion Expert opinion Expert opinion without Expert opinion without explicit critical explicit critical appraisal, without explicit critical without explicit critical explicit critical appraisal, explicit critical appraisal, or based on or based on physiology, appraisal, or based on appraisal, or based on or based on physiology, appraisal, or based on physiology, bench bench research or "first physiology, bench physiology, bench bench research or "first economic theory or research or "first principles"; or non- research or "first research or "first principles" "first principles" principles" randomised studies with unvalidated surrogate outcomes principles" principles"
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KCE reports vol.45A Colorectale Kan
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2 Screening for Colorectal Cancer K
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10 Screening for Colorectal Cancer
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KCE reports 1. Effectiviteit en kos
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