{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T14:50:07Z","timestamp":1781016607217,"version":"3.54.1"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2014,12,10]],"date-time":"2014-12-10T00:00:00Z","timestamp":1418169600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2014,12,10]],"date-time":"2014-12-10T00:00:00Z","timestamp":1418169600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"name":"Department of Epidemiology, Lazio Regional Health Service"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2015,6]]},"abstract":"Abstract<\/jats:title>\n \n Background and Aims<\/jats:title>\n \n The World Health Organization (\n WHO<\/jats:styled-content>\n ), and a growing number of other organizations, have adopted the\n G<\/jats:styled-content>\n rading of\n R<\/jats:styled-content>\n ecommendations,\n A<\/jats:styled-content>\n ssessment,\n D<\/jats:styled-content>\n evelopment and\n E<\/jats:styled-content>\n valuation (\n GRADE<\/jats:styled-content>\n ) system in order to both assess the quality of research evidence and develop clinical practice guidelines. In 2009\n WHO<\/jats:styled-content>\n published a guideline on psychosocially assisted pharmacological treatment of opioid dependence, based on the results of\n C<\/jats:styled-content>\n ochrane\n R<\/jats:styled-content>\n eviews summarized using the\n GRADE<\/jats:styled-content>\n methodology. The main features of this system are an a priori definition of outcomes and their relevance, and distinction between the quality of evidence (also referred to as confidence in the estimate of intervention effect) and the strength of recommendations. We consider how successful this approach has been.\n <\/jats:p>\n <\/jats:sec>\n \n Analysis and Evidence<\/jats:title>\n \n We discuss the merits and limitations of using\n C<\/jats:styled-content>\n ochrane\n R<\/jats:styled-content>\n eviews and\n GRADE<\/jats:styled-content>\n framework in developing guidelines in the field of drug addiction. In 2009 a panel of multi\u2010disciplinary international experts identified 15 clinical questions and eight relevant outcomes.\n C<\/jats:styled-content>\n ochrane reviews were available for each clinical question and four outcomes. The panel formulated 15 recommendations. Eight recommendations were classified as strong, two of which were based on high\u2010quality evidence and three on very low\u2010quality evidence. For example, the strong recommendation to use methadone in adequate doses in preference to buprenorphine was based on high\u2010quality evidence, while the strong recommendation not to use the combination of opioid antagonists with heavy sedation in the management of opioid withdrawal was based on low\u2010quality evidence.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n An explicit stepwise process of moving from evaluation of the quality of evidence to the definition of the strength of recommendations is important in providing practical and clear clinical guidance for practitioners and policy\u2010makers in addiction.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/add.12788","type":"journal-article","created":{"date-parts":[[2014,12,10]],"date-time":"2014-12-10T02:46:50Z","timestamp":1418179610000},"page":"891-898","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["The role of\n C<\/scp>\n ochrane reviews in informing international guidelines: a case study of using the\n G<\/scp>\n rading of\n R<\/scp>\n ecommendations,\n A<\/scp>\n ssessment,\n D<\/scp>\n evelopment and\n E<\/scp>\n valuation system to develop World Health Organization guidelines for the psychosocially assisted pharmacological treatment of opioid dependence"],"prefix":"10.1111","volume":"110","author":[{"given":"Marina","family":"Davoli","sequence":"first","affiliation":[{"name":"Department of Epidemiology Lazio Regional Health Service Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Amato","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Lazio Regional Health Service Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Clark","sequence":"additional","affiliation":[{"name":"Mental Health and Substance Abuse World Health Organization Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Farrell","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre University of New South Wales Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Hickman","sequence":"additional","affiliation":[{"name":"School of Social and Community Medicine University of Bristol Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Hill","sequence":"additional","affiliation":[{"name":"The School of Medicine University of Melbourne Melbourne Vic Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Magrini","sequence":"additional","affiliation":[{"name":"Drug Evaluation Unit WHO Collaborating Centre in Evidence\u2010Based Research Synthesis and Guideline Development Emilia Romagna Health and Social Care Agency Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vladimir","family":"Poznyak","sequence":"additional","affiliation":[{"name":"Mental Health and Substance Abuse World Health Organization Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holger J.","family":"Sch\u00fcnemann","sequence":"additional","affiliation":[{"name":"Departments of Clinical Epidemiology & Biostatistics and of Medicine McMaster University Health Sciences Centre Hamilton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,12,10]]},"reference":[{"key":"e_1_2_5_2_1","unstructured":"Economic and Social Council.2014.ECOSOC resolution 2004\/40. Available at:http:\/\/www.un.org\/docs\/ecosoc\/documents\/2004\/resolutions\/eres2004\u201040.pdf(accessed 15 March 2013) (Archived athttp:\/\/www.webcitation.org\/6UAlgr1jKon 18 November 2014)."},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60675-8"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67159-0"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)08523-9"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(99)00028-8"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60676-X"},{"key":"e_1_2_5_8_1","unstructured":"World Health Organization (WHO).2012WHO Handbook for guideline development. Available at:http:\/\/apps.who.int\/iris\/bitstream\/10665\/75146\/1\/9789241548441_eng.pdf(accessed 24 April 2013) (Archived athttp:\/\/www.webcitation.org\/6UAkngUiuon 18 November 2014)."},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39489.470347.AD"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/1478-4505-4-12"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.04.026"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.328.7454.1490"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0040119"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(06)70684-3"},{"key":"e_1_2_5_15_1","volume-title":"Guidelines for the Psychosocially Assisted Pharmacological Treatment of Opioid Dependence","author":"World Health Organization (WHO)","year":"2009"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39490.551019.BE"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2009.01973.x"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858"},{"key":"e_1_2_5_19_1","unstructured":"National Institute for Health and Care Excellence (NICE).National Institute of Clinical Excellence Technology Appraisal Guidance 114.2006. Methadone and buprenorphine for the management of opioid dependence. Available at:http:\/\/www.nice.org.uk(accessed 15 March 2013) (Archived athttp:\/\/www.webcitation.org\/6UAku4Kpgon 18 Novembre 2014)."},{"key":"e_1_2_5_20_1","unstructured":"BargagliA. DavoliM. MinozziS. VecchiS. PerucciC.A Systematic Review of Observational Studies on Treatment of Opioid Dependence.2007. Geneva Switzerland background document prepared for third meeting of Technical Development Group (TDG) for the WHO Guidelines for Psychosocially Assisted Pharmacotherapy of Opiod Dependence 17\u201321 September. Available at:http:\/\/www.who.int\/substance_abuse\/activities\/observational_studies_treatment.pdf(accessed 15 March 2013) (Archived athttp:\/\/www.webcitation.org\/6UAlzqZJTon 18 November 2014)."},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD002208"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2007-1907"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858"},{"key":"e_1_2_5_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-8-6"}],"container-title":["Addiction"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fadd.12788","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fadd.12788","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/add.12788","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/add.12788","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/add.12788","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T03:06:11Z","timestamp":1780974371000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/add.12788"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,12,10]]},"references-count":26,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2015,6]]}},"alternative-id":["10.1111\/add.12788"],"URL":"https:\/\/doi.org\/10.1111\/add.12788","archive":["Portico"],"relation":{},"ISSN":["0965-2140","1360-0443"],"issn-type":[{"value":"0965-2140","type":"print"},{"value":"1360-0443","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,12,10]]},"assertion":[{"value":"2013-09-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-10-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-12-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}