Zhang Y, Akl EA, Schünemann HJ, et al.
Research synthesis methods. Date of publication 2018 Jul 14;volume ():.
1. Res Synth Methods. 2018 Jul 14. doi: 10.1002/jrsm.1313. [Epub ahead of print]
Using systematic reviews in guideline development: the GRADE approach.
Zhang Y(1), Akl EA(1)(2), Schünemann HJ(1)(3).
Author information:
(1)Department of Health Research Methods, Evidence, and Impact, McMaster
University, Canada.
(2)Department of Internal Medicine, Faculty of Medicine, American University of
Beirut, Lebanon.
(3)Department of Medicine, McMaster University, Canada.
Systematic reviews are essential to produce trustworthy guidelines. To assess the
certainty of a body of evidence included in a systematic review the Grading of
Recommendations Assessment, Development and Evaluation (GRADE) working group has
developed an approach that is currently used by over 100 organisations, including
the World Health Organization and the Cochrane Collaboration. GRADE provides
operational definitions and instructions to rate the certainty of the evidence
for each outcome in a review as high, moderate, low, or very low for the effects
of interventions, prognostic estimates, values and preferences, test accuracy and
resource utilization. The assessment includes assessing risk of bias,
imprecision, inconsistency, indirectness, and publication bias, the magnitude of
effects, dose-response relations and the impact of residual confounding and bias.
Summary statistical information and assessments of certainty are presented in
GRADE evidence summary tables, which can be produced using GRADE's official
GRADEpro software tool (www.gradepro.org/). The evidence summary tables feed into
the GRADE Evidence to Decision frameworks which guideline panels can use to
produce recommendations.
This article is protected by copyright. All rights reserved.
DOI: 10.1002/jrsm.1313
PMID: 30006970
