Table 4 Judgements by the Guideline Development Group (GDG) in Evidence to decision framework for the question: Should multigene tests be used in patients who have hormone receptor-positive, HER-2 negative, lymph node-negative or up to 3 lymph nodes-positive invasive breast cancer to guide the use of adjuvant chemotherapy?
21-gene recurrence score (limited to women with negative lymph nodes) | 70-gene signature assay | ||
|---|---|---|---|
Low clinical risk | High clinical risk | ||
Problem | Yes | Yes | Yes |
Desirable effects | Large | Trivial | Large |
Undesirable effects | Trivial | Trivial | Small |
Certainty of evidence | Very low | Low | Low |
Values | Probably no important uncertainty or variability | Probably no important uncertainty or variability | Probably no important uncertainty or variability |
Balance of effects | Probably favours the intervention | Favours the comparison | Probably favours the intervention |
Resources required | Large costs | Large costs | Large savings |
Certainty of evidence of required resources | Very low | Very low | Very low |
Cost effectiveness | No included studies | No included studies | No included studies |
Equity | Probably reduced | Probably reduced | Probably reduced |
Acceptability | Varies | Varies | Varies |
Feasibility | Varies | Varies | Varies |
Final recommendation | Conditional in favour of the intervention | Strong against intervention | Conditional in favour of the intervention |
