Consensus-based Statements rely on evidence from expert opinion of the IAPD Science Committee or other expert opinion documents, such as AAPD Best Practices documents Consensus-based Recommendations rely on published high-quality evidence such as clinical trials, or metaanalyses of clinical trials. Evidence-based Recommendations rely on published clinical practice guidelines, which are the highest level of evidence, based on a systematic review/or analysis of systematic reviews to answer predetermined questions. Clinical practice guidelines also evaluate the level of certainty of evidence, patient values/preferences, resource allocation, and acceptability/feasibility of an intervention.
Each IAPD Consensus-based Recommendation or Statement was evaluated to determine applicability to
global clinical practices. Seventy-nine IAPD members, distributed internationally, reviewed the guidelines
and rated the recommendations using a 9-point Likert Scale, from strongly disagree to strongly agree. The
average number of evaluators for each recommendation was 23. The agreement (moderately/mostly/strongly
agree) reflects concordance between the consensus-based statement/recommendation and current global
practices. IAPD recommendations, after re-evaluation, that did not reach an agreement of 70% or higher
were considered to not have global agreement and were eliminated. Those IAPD recommendations that are
classified as an “evidence-base recommendation” or “endorsement from other organizations” were not scored
(Not Applicable, N/A) because they already are standards of care based on systematic reviews.
