The KDIGO clinical practice guidelines for the care of kidney transplant recipients.
The clinical guideline for care of renal transplant recipients was written by a committee of 15 people from nine countries, supported by an evidence review team The scope of the review was care of the patient after a renal transplant-not evaluation or selection of recipients and donors, focusing on the issue specific to the immunosuppressed transplant patient. A total of 12,327 articles comprising 3168 randomized controlled trials, 7543 cohort studies, and 1609 reviews were selected by a formal search. Each article was formally evaluated for the quality of the data from A to D. A consistent set of statements were based on the strength of the evidence. Level 1 evidence: "we recommend" means that if you were a patient, most people would want to do this; if a clinician, you should recommend this course of action to most patients; and if a policy maker, you should adopt this as a reasonable standard. Level 2 evidence: "we suggest" means the majority of patients would want do this; to the clinician, it means that different solutions may well be needed for different patients; whereas to the health policy maker, this is a strong warning to engage stakeholders in the creation of a particular local policy. Because 69% of the advice is "suggested" on the basis of level C or D evidence, one outcome of this work is to make it clear where the current evidence for clinical decisions runs out of data.
Chapman
Jeremy R
JR
The Transplantation Society, Centre for Transplant and Renal Research, Millennium Institute, Westmead Hospital, University of Sydney, Westmead, NSW, Australia.
D022126:Access to Information; D019317:Evidence-Based Medicine / Q000592:standards*; D019983:Guideline Adherence; D006801:Humans; D007165:Immunosuppression Therapy / Q000592:standards*; D016030:Kidney Transplantation / Q000592:standards*; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome