What does expert opinion in guidelines mean? a meta-epidemiological study

Oscar J. Ponce, Neri Alvarez-Villalobos, Raj Shah, Khaled Mohammed, Rebecca L. Morgan, Shahnaz Sultan, Yngve Falck-Ytter, Larry J. Prokop, Philipp Dahm, Reem A. Mustafa, Mohammad H. Murad

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Guidelines often use the term expert opinion (EO) to qualify recommendations. We sought to identify the rationale and evidence type in EO recommendations. We searched multiple databases and websites for contemporary guidelines published in the last decade that used the term EO. We identified 1106 references, of which 69 guidelines were included (2390 recommendations, of which 907 were qualified as EO). A rationale for using EO designation was not provided in most (91%) recommendations. The most commonly cited evidence type was extrapolated from studies that did not answer guideline question (40% from randomised trials, 38% from observational studies and 2% from case reports or series). Evidence extrapolated from populations that were different from those addressed in the guideline was found in 2.5% of EO recommendations. We judged 5.6% of EO recommendations as ones that could have been potentially labelled as good practice statements. None of the EO recommendations were explicitly described as being solely dependent on the clinical experience of the panel. The use of EO as a level of evidence in guidelines remains common. A rationale for such use is not explicitly provided in most instances. Most of the time, evidence labelled as EO was indirect evidence and occasionally was very low-quality evidence derived from case series. We posit that the explicit description of evidence type, as opposed to using the label EO, may add clarity and transparency and may ultimately improve uptake of recommendations.

Original languageEnglish (US)
Pages (from-to)164-169
Number of pages6
JournalEvidence-Based Medicine
Volume22
Issue number5
DOIs
StatePublished - Oct 1 2017

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Expert Testimony
Epidemiologic Studies
Guidelines
Observational Studies
Databases

Keywords

  • Epidemiology

Cite this

Ponce, O. J., Alvarez-Villalobos, N., Shah, R., Mohammed, K., Morgan, R. L., Sultan, S., ... Murad, M. H. (2017). What does expert opinion in guidelines mean? a meta-epidemiological study. Evidence-Based Medicine, 22(5), 164-169. https://doi.org/10.1136/ebmed-2017-110798

What does expert opinion in guidelines mean? a meta-epidemiological study. / Ponce, Oscar J.; Alvarez-Villalobos, Neri; Shah, Raj; Mohammed, Khaled; Morgan, Rebecca L.; Sultan, Shahnaz; Falck-Ytter, Yngve; Prokop, Larry J.; Dahm, Philipp; Mustafa, Reem A.; Murad, Mohammad H.

In: Evidence-Based Medicine, Vol. 22, No. 5, 01.10.2017, p. 164-169.

Research output: Contribution to journalArticle

Ponce, OJ, Alvarez-Villalobos, N, Shah, R, Mohammed, K, Morgan, RL, Sultan, S, Falck-Ytter, Y, Prokop, LJ, Dahm, P, Mustafa, RA & Murad, MH 2017, 'What does expert opinion in guidelines mean? a meta-epidemiological study', Evidence-Based Medicine, vol. 22, no. 5, pp. 164-169. https://doi.org/10.1136/ebmed-2017-110798
Ponce OJ, Alvarez-Villalobos N, Shah R, Mohammed K, Morgan RL, Sultan S et al. What does expert opinion in guidelines mean? a meta-epidemiological study. Evidence-Based Medicine. 2017 Oct 1;22(5):164-169. https://doi.org/10.1136/ebmed-2017-110798
Ponce, Oscar J. ; Alvarez-Villalobos, Neri ; Shah, Raj ; Mohammed, Khaled ; Morgan, Rebecca L. ; Sultan, Shahnaz ; Falck-Ytter, Yngve ; Prokop, Larry J. ; Dahm, Philipp ; Mustafa, Reem A. ; Murad, Mohammad H. / What does expert opinion in guidelines mean? a meta-epidemiological study. In: Evidence-Based Medicine. 2017 ; Vol. 22, No. 5. pp. 164-169.
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