the potential clinical impact—appraisal of the precision, size and clinical importance or relevance of the primary outcomes used to determine the safety and effectiveness of the test; the generalisability of the evidence to the target population; and the applicability of the evidence—integration of the evidence for conclusions about the net clinical benefit of the intervention in the context of Australian clinical practice. A matrix for assessing the body of evidence for each research question, according to the components above, was used for this assessment (Table 14). Table 14 Body of evidence matrix Component A B C D Excellent Good Satisfactory Poor Evidence-base a One or more level I One or two level II One or two level III Level IV studies, or studies with a low studies with a low risk studies with a low risk level I to III risk of bias or of bias, or an SR or of bias, or level I or II studies/SRs with a several level II several level III studies studies with a high risk of bias studies with a low with a low risk of bias moderate risk of bias risk of bias Consistency b All studies Most studies consistent Some inconsistency Evidence is consistent and inconsistency may reflecting genuine inconsistent be explained uncertainty around clinical question Clinical impact Very Substantial Moderate Slight or restricted Generalisability Population(s) Population(s) studied in Population(s) studied Population(s) studied studied in body of the body of evidence in body of evidence in body of evidence evidence are the are similar to target differ to target differ from target same as target population population for population and hard it population guideline but it is is to judge whether it is clinically sensible to sensible to generalise apply this evidence to to target population target population c Applicability Directly applicable Applicable to Australian Probably applicable Not applicable to to Australian healthcare context with to Australian Australian healthcare healthcare context few caveats healthcare context context with some caveats Source: adapted from ) a Level of evidence determined from the NHMRC evidence hierarchy (see Table 12) b If there is only one study, rank this component as applicable’ ‘not c For example, results in adults that are clinically sensible to apply to children OR psychosocial outcomes for one cancer that may be applicable to patients with another cancer SR = systematic review; several = more than two studies
the potential clinical impact—appraisal of the precision, size and clinical importance or relevance of the primary outcomes used to determine the safety and effectiveness of the test; the generalisability of the evidence to the target population; and the applicability of the evidence—integration of the evidence for conclusions about the net clinical benefit of the intervention in the context of Australian clinical practice. A matrix for assessing the body of evidence for each research question, according to the components above, was used for this assessment (Table 14). Table 14 Body of evidence matrix Component A B C D Excellent Good Satisfactory Poor Evidence-base a One or more level I studies with a low risk of bias or several level II studies with a low risk of bias One or two level II studies with a low risk of bias, or an SR or several level III studies with a low risk of bias One or two level III studies with a low risk of bias, or level I or II studies with a moderate risk of bias Level IV studies, or level I to III studies/SRs with a high risk of bias Consistency b All studies consistent Most studies consistent and inconsistency may be explained Some inconsistency reflecting genuine uncertainty around clinical question Evidence is inconsistent Clinical impact Very Substantial Moderate Slight or restricted Generalisability Population(s) studied in body of evidence are the same as target population Population(s) studied in the body of evidence are similar to target population Population(s) studied in body of evidence differ to target population for guideline but it is clinically sensible to apply this evidence to target population c Population(s) studied in body of evidence differ from target population and hard it is to judge whether it is sensible to generalise to target population Applicability Directly applicable to Australian healthcare context Applicable to Australian healthcare context with few caveats Probably applicable to Australian healthcare context with some caveats Not applicable to Australian healthcare context Source: adapted from ) a Level of evidence determined from the NHMRC evidence hierarchy (see Table 12) b If there is only one study, rank this component as ‘not applicable’ c For example, results in adults that are clinically sensible to apply to children OR psychosocial outcomes for one cancer that may be applicable to patients with another cancer SR = systematic review; several = more than two studies
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