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Methodology for clinical practice guidelines for the management of arteriovenous access.

Abstract：

:The Society for Vascular Surgery considers the placement and maintenance of arteriovenous hemodialysis access to be an important component of any vascular surgery practice. Therefore, the Society has long been involved in setting the standards for the management of arteriovenous access. Formulating clinical recommendations in this area is the latest effort by the Society to improve the management of arteriovenous access on a national level. To provide an unbiased study of the evidence and to help in formulating the recommendations, the Society used the Knowledge and Encounter Research (KER) Unit of the Mayo Clinic College of Medicine, Rochester, Minn, to review the available evidence and advise a multidisciplinary group of access surgeons and nephrologists in formulating the clinical recommendations. To review the evidence, randomized and observational study designs were both considered. Whenever possible, systematic reviews and meta-analyses of the literature were used because, compared with individual studies, they generate more precise estimates of treatment effects and their results are applicable to a wider range of patients. On behalf of the Society, the group issued its recommendations following the Grading of Recommendations Assessment, Development and Evaluation (GRADE) format; this format disentangles the strength of recommendations from the quality of the evidence and encourages statements about the underlying values and preferences relevant to the particular recommendation. The recommendations are classified as strong (denoted by the phrase "we recommend") or weak (denoted by the phrase "we suggest"); and the quality of evidence is classified as high, moderate, low, or very low. These recommendations are not meant to supersede clinical judgment; rather, they should be used as a guide for the practicing surgeon and nephrologist as the decision is being made for the placement and subsequent procedures and management of arteriovenous hemodialysis access are being considered.

journal_name

J Vasc Surg

journal_title

Journal of vascular surgery

authors

Murad MH,Swiglo BA,Sidawy AN,Ascher E,Montori VM

doi

10.1016/j.jvs.2008.08.045

subject

Has Abstract

pub_date

2008-11-01 00:00:00

pages

26S-30S

issue

5 Suppl

eissn

0741-5214

issn

1097-6809

pii

S0741-5214(08)01396-7

journal_volume

pub_type

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Methodology for clinical practice guidelines for the management of arteriovenous access.