Aggregation of Clinical Evidence Using Argumentation: A Tutorial Introduction
In this tutorial, we describe a new framework for representing and synthesizing knowledge from clinical trials involving multiple outcome indicators. The framework offers a formal approach to aggregating clinical evidence. Based on the available evidence, arguments are generated for claiming that one treatment is superior, or equivalent, to another. Evidence comes from randomized clinical trials, systematic reviews, meta-analyses, network analyses, etc. Preference criteria over arguments are used that are based on the outcome indicators, and the magnitude of those outcome indicators, in the evidence. Meta-arguments attack (i.e. they are counterarguments to) arguments that are based on weaker evidence. An evaluation criterion is used to determine which are the winning arguments, and thereby the recommendations for which treatments are superior. Our approach has an advantage over meta analyses and network analyses in that they aggregate evidence according to a single outcome indicator, whereas our approach combines evidence according to multiple outcome indicators.
KeywordsPreference Relation Aggregation Process Outcome Indicator Structure Argument Grade Approach
The authors would like to thank Jiri Chard and Cristina Visintin for valuable feedback on this tutorial.
- 9.Hunter, A., Williams, M.: Using clinical preferences in argumentation about evidence from clinical trials. In: Veinot, T., et al. (eds.) Proceedings of the First ACM International Health Informatics Symposium, pp. 118–129. ACM Press (2010)Google Scholar
- 10.Kirkwood, B., Sterne, J.: Essential Medical Statistics. Blackwell, Oxford (2003)Google Scholar
- 12.Liddle, J., Williamson, M., Irwig, L.: Method for Evaluating Research and Guideline Evidence. New South Wales Health Department, Sydney (1996)Google Scholar
- 14.NICE. Glaucoma: Clinical Guidelines CG85. London, UK: National Institute for Health and Clinical Excellence (2009). www.nice.org.uk. Accessed 1 April 2012
- 15.NICE. The Guidelines Manual. National Institute for Health and Clinical Excellence (2009)Google Scholar
- 16.N. O’Rourke et al. “Concurrent chemoradiotherapy in non-small cell lung cancer”. In: Cochrane Database of Systematic Reviews. Article. No.: CD002140. 6 (2010). doi: 10.1002/14651858
- 18.SIGN. SIGN 50: A Guideline Developers Handbook. Scottish Intercollegiate Guidelines Network (2011)Google Scholar