1.f. The Formulation of the Evidence into the Guidelines

In order to consider the evidence for each of the 23 questions, the panel met in groups of 6 to 10 members. During the first round of considering the evidence, 12 small groups of panel members were randomly assigned to consider the evidence for 2 or 3 questions. They developed evidence statements and determined the strength of the evidence using the criteria noted in Table A-I.  Their recommendations were presented to the full panel, which then made additional recommendations regarding their conclusions.

After considering additional studies for questions where adequate RCTs were not available, another iteration of evidence statements and recommendations was developed. The full panel met again to consider this iteration, which was considered by small groups assigned to focus on either a specific treatment modality or outcome measure. The small groups brought their recommendations back to the full panel for their final consideration. The panel weighed the evidence based on a thorough examination of the threshold or magnitude of the treatment effect.

Criteria:

Each evidence statement (other than those with no available evidence) and each recommendation is categorized by a level of certainty (A through D) as described in Table A-I below. The consensus process used for drawing conclusions and writing the recommendations was a group process that took into account all opinions.  Conclusions reflect the widest possible agreement of the panel.