➡️Methods of development
Stakeholder Involvement: Individuals who were involved in the development process. Included the above-mentioned Head and Neck Chief Manager, Head and Neck Executive Manager, Assembly Board, Grading Board and Reviewing Board.
Information about target population experiences was not applicable for this topic.
➡️Search Method
Pubmed, Medline, Egyptian Knowledge Bank, Medscape, WebMD, Google Scholar
➡️Keywords
Laryngeal cancer, chemotherapy, chemoradiation, laryngeal preservation.
➡️The adaptation cycle passed over: set-up phase, adaptation phase (Search and screen, assessment: currency, content, quality & /decision/selection) and finalization phase that included revision and external reviewing and Other related specialties Reviewing Board including phoniatrics & speech specialist, Clinical oncology & radiotherapy specialist and nurse.
➡️Time period searched: from January 2009 to March 2020.
➡️Results
Three guidelines were assessed by 7 experts Laryngologists and the International Consensus on laryngeal cancer 2021 had the highest scores as regards to the currency, contents and quality. It was graded GRADE by 19 expert Laryngologists and reviewed by 3 expert reviewers. To improve quality, gather feedback on draft recommendations. The external review was done through a rating scale as well as open-ended questions. (Annexes tables 1-3) (1).
➡️Setting: Primary, secondary and tertiary care centers & hospitals, and related specialties.Interpretation of strong and conditional recommendations for an intervention 10
Audience |
Strong recommendation |
Conditional recommendation |
Patients |
Most individuals in this situation would want the recommended course of action; only a small proportion would not. Formal decision aides are not likely to be needed to help individuals make decisions consistent with their values and preferences. |
Most individuals in this situation would want the suggested course of action, but many would not |
Clinicians |
Most individuals should receive the intervention. Adherence to the recommendation could be used as a quality criterion or performance indicator. |
Different choices will be appropriate for individual patients, who will require assistance in arriving at a management decision consistent with his or her values and preferences. Decision aides may be useful in helping individuals make decisions consistent with their values and preferences. |
Policymakers |
The recommendation can be adopted as policy in most situations. |
Policy-making will require substantial debate and involvement of various stakeholders. |
The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to Decision frameworks (GRADE Working Group 2013)
Grade |
Definition |
High
|
We are very confident that the true effect lies close to that of the estimate of the effect. |
Moderate
|
We are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different |
Low
|
Our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. |
Very Low
|
We have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect |