Extract
Since 2011, the World Health Organization (WHO) has used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system for grading quality of evidence [1, 2] to update guidelines for the management of drug-resistant tuberculosis (DR-TB). This represents an undeniable improvement towards evidence-based recommendations compared to previous guidelines, which were primarily based on expert opinion [3]. However, some aspects of guideline development remain unclear. In our opinion, the WHO 2019 consolidated guidelines on DR-TB treatment [4] have raised some concerns in the way recommendations were drawn from the evidence evaluated to answer specific PICO (Patient, Intervention, Comparator, Outcome) questions.
Abstract
World Health Organization guidelines on drug-resistant tuberculosis should make a clear distinction between evidence, expert opinion and assumptions to allow appreciation of the uncertainty around the recommendations http://bit.ly/2FHxmyW
Footnotes
Author contributions: L. Guglielmetti and F. Varaine made a substantial contribution to the conception of the work, wrote the manuscript, critically revised the manuscript for important intellectual content, and gave final approval of the current version to be published. H. Huerga and U. Khan critically revised the manuscript for important intellectual content and gave final approval of the current version to be published.
Conflict of interest: L. Guglielmetti is co-principal investigator of endTB and endTB-Q clinical trials.
Conflict of interest: H. Huerga has nothing to disclose.
Conflict of interest: U. Khan has nothing to disclose.
Conflict of interest: F. Varaine is director of the endTB project for MSF.
- Received October 1, 2019.
- Accepted December 19, 2019.
- Copyright ©ERS 2020