Updating the Guideline Methodology of the Healthcare Infection Control Practices Advisory Committee (HICPAC)
Updating the Guideline Methodology of the Healthcare Infection Control Practices Advisory Committee (HICPAC) The complete guideline is available for download in PDF format (188 KB / 31 pages).
Table 1: Rating the Quality of Evidence for Therapy or Harm Studies Using the GRADE Approach
|Type of Evidence||Initial Grade||Criteria to Decrease Grade||Criteria to Increase Grade||Overall Quality Grade|
Publication biasHigh risk of bias (-1 grade)
Unmeasured ConfoundersInclusion of unmeasured confounders increases the effect size (+1 grade)
|Any other evidence (e.g., expert opinion)||Very Low||Very Low|
Abbreviations: Grading of Recommendations Assessment, Development and Evaluation (GRADE); Randomized Controlled Trial (RCT).
Table 2: Formulating Recommendations
|HICPAC Recommendation||Weighing Benefits and Harms for Critical Outcomes||Quality of Evidence|
|STRONG (Category I)||Interventions with net benefits or net harms||Category IA – High to Moderate
Category IB – Low to Very Low (Established Practice)
Category IC – High to Very Low (Regulatory)
|WEAK (Category II)||Interventions with trade offs between benefits and harms||High to Very Low|
|No recommendation/unresolved Issue||Uncertain trade offs between benefits and harms||Low to Very Low|
Table 3. Updated HICPAC Categorization Scheme for Recommendations
|Category IA||A strong recommendation supported by high to moderate quality evidence suggesting net clinical benefits or harms.
A strong recommendation supported by low quality evidence suggesting net clinical benefits or harms, or an accepted practice (e.g., aseptic technique) supported by low to very low quality evidence.
A strong recommendation required by state or federal regulation.
|Category II||A weak recommendation supported by any quality evidence suggesting a trade off between clinical benefits and harms.|
|No Recommendation||An unresolved issue for which there is low to very low quality evidence with uncertain trade offs between benefits and harms.|