An explanation of PROSPECT methodology and Working Group processes can be found at the following link: http://esraeurope.org/prospect-methodology
For the complex spine surgery review, the Subgroup members were:
All included studies were assessed for quality according to PROSPECT methodology (Joshi 2019, http://esraeurope.org/prospect-methodology). The study quality assessments for complex spine surgery are summarised here: Quality assessments and level of evidence assigned to included trials.
The methodology of the PROSPECT group is unique in that it aims to synthesis clinical evidence while considering risks and beneﬁts of interventions, as well as taking into account study design. Speciﬁcally, the group seeks to determine the relevance of study interventions in current peri-operative care practice, and critically evaluate the baseline pain treatment.
Recommendations are given when at least two congruent studies support an intervention. Recommendations were made according to PROSPECT methodology (Joshi 2019, http://esraeurope.org/prospect-methodology). This involved a grading of A–D according to the overall level of evidence, as determined by the quality of studies included, consistency of evidence and study design: Relationship between quality of the study and levels of evidence and grades of recommendation.
The proposed recommendations were sent to the PROSPECT Working Group for review and comments. A panel discussion took place, which included several rounds of individual comments followed by round-table discussions. Following a round of discussion during the face-to-face meeting, the Working Group unanimously agreed with the proposed recommendations.
The limitations of this review are related to those of the included studies:
The AGREE II instrument (Brouwers 2010) is used internationally to assess the methodological rigour and transparency of practice guidelines. As far as possible, the methodology of the PROSPECT Complex spine surgery review meets the requirements of ‘Domain 3: Rigour of development’ of the AGREE II instrument: