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

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190 Screening for Colorectal Cancer: Appendices KCE reports vol.45 SIGN The Scottish Intercollegiate Guidelines Network (SIGN 49) published (2001) concise rating schemes for appraisal of the strength of evidence given by reviewed scientific articles. Different grades of recommendation relate to the strength of the evidence on which they are based: I. Levels of Evidence: 1 ++ : High quality meta-analyses, systematic reviews of randomised controlled trials (RCTs), or RCTs with a very low risk of bias 1 + : Well-conducted meta-analyses, systematic reviews of RCTs, or RCTs with a low risk of bias 1 : Meta-analyses, systematic reviews of RCTs, or RCTs with a high risk of bias 2 ++ : High quality systematic reviews of case control or cohort studies or high quality case control or cohort studies with a very low risk of confounding or bias and a high probability that the relationship is causal 2+ : Well-conducted case control or cohort studies with a low risk of confounding or bias and a moderate probability that the relationship is causal 2 : Case control or cohort studies with a high risk of confounding or bias and a significant risk that the relationship is not causal 3 : Non-analytic studies, e.g. case reports, case series 4 : Expert opinion II. Grades of recommendation: The grade of recommendation relates to the strength of the evidence on which the recommendation is based. It does not reflect the clinical importance of the recommendation. A : At least one meta-analysis, systematic review of RCTs, or RCT rated as 1 ++ and directly applicable to the target population; or a body of evidence consisting principally of studies rated as 1 +, directly applicable to the target population, and demonstrating overall consistency of results B : A body of evidence including studies rated as 2++ directly applicable to the target population, and demonstrating overall consistency of results; or extrapolated evidence from studies rated as 1++ or 1+ C : A body of evidence including studies rated as 2+, directly applicable to the target population and demonstrating overall consistency of results; or extrapolated evidence from studies rated as 2++ D : Evidence level 3 or 4; or extrapolated evidence from studies rated as 2+
KCE reports vol.45 Screening for Colorectal Cancer: Appendices 191 New Zealand Guidelines Group (NSGG) The evidence-grading hierarchy used by the initial 1998 National Health Committee working party: Grade 1: RCT (randomised controlled trials can control for various forms of bias associated with screening). Grade 2: Non-RCT (randomisation is needed to minimise bias and confounding). Grade 3: Non-randomised historical cohort studies, casecontrol and other population studies (compare current outcomes due to intervention with previous outcomes, which may permit inappropriate groups to be compared). Grade 4: Case series (data are derived from a group of unselected individuals, and are limited in value). Grade 5: Expert (consensus) opinion (not evidence per se, but may have value where evidence is not likely to be or become available). British Society of Gastroenterology (BSG) Association of Coloproctology for Great Britain and Ireland (ACPGBI) I. Categories of evidence II. Grading of recommendations Ia: Evidence obtained from meta-analysis of randomised controlled trials. Ib: Evidence obtained from at least one randomised controlled trial. IIa: Evidence obtained from at least one well designed controlled study without randomisation. IIb: Evidence obtained from at least one other type of well designed quasi-experimental study. III: Evidence obtained from a well designed non-experimental descriptive study, such as comparative studies, correlation studies, and case studies. IV: Evidence obtained from expert committee reports or opinions or clinical experiences of respected authorities. The strength of each recommendation is dependent upon the category of the evidence supporting it, and is graded according to the following system. A: Evidence categories Ia and Ib. B: Evidence categories IIa, IIb, III. C: Evidence category IV.
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KCE reports vol.45A Colorectale Kan
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2 Screening for Colorectal Cancer K
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KCE reports 1. Effectiviteit en kos
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