Incorporating considerations of resources use into grading recommendations.Guyatt GH, Oxman AD, Kunz R, Jaeschke R, Helfand M, Liberati A, Vist GE, Schünemann HJ; GRADE working group. BMJ. 2008 May 24;336(7654):1170-3.
In this last part of a series describing the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to making recommendations we will look at how guideline panellists and clinicians can incorporate matters related to the use of resources into recommendations and practice. Clinical recommendations inevitably involve judgments about the allocation of resources, judgments commonly referred to as costs. We will deal with some of the challenges of considering costs, explain reasons for focusing on resource use rather than costs, and discuss how to incorporate considerations of resource use into recommendations.Cost as an outcome presents special challenges .In one sense, cost is just another potentially important outcome—like mortality, morbidity, and quality of life—associated with alternative ways of managing patients. In addition to these clinical outcomes, an intervention may increase costs or decrease costs. However, costs differ from other outcomes in several ways .