TY - JOUR
T1 - The GRADE Working Group clarifies the construct of certainty of evidence
AU - Hultcrantz, Monica
AU - Rind, David
AU - Akl, Elie A
AU - Treweek, Shaun
AU - Mustafa, Reem A
AU - Iorio, Alfonso
AU - Alper, Brian S
AU - Meerpohl, Joerg
AU - Murad, M Hassan
AU - Ansari, Mohammed T
AU - Katikireddi, Srinivasa Vittal
AU - Östlund, Pernilla
AU - Tranæus, Sofia
AU - Christensen, Robin
AU - Gartlehner, Gerald
AU - Brozek, Jan
AU - Izcovich, Ariel
AU - Schunemann, Holger J
AU - Guyatt, Gordon
N1 - Copyright © 2017. Published by Elsevier Inc.
PY - 2017/5/18
Y1 - 2017/5/18
N2 - OBJECTIVE: To clarify the GRADE (grading of recommendations assessment, development and evaluation) definition of certainty of evidence and suggest possible approaches to rating certainty of the evidence for systematic reviews, health technology assessments and guidelines.STUDY DESIGN AND SETTING: This work was carried out by a project group within the GRADE Working Group, through brainstorming and iterative refinement of ideas, using input from workshops, presentations, and discussions at GRADE Working Group meetings to produce this document, which constitutes official GRADE guidance.RESULTS: Certainty of evidence is best considered as the certainty that a true effect lies on one side of a specified threshold, or within a chosen range. We define possible approaches for choosing threshold or range. For guidelines, what we call a fully contextualized approach requires simultaneously considering all critical outcomes and their relative value. Less contextualized approaches, more appropriate for systematic reviews and health technology assessments, include using specified ranges of magnitude of effect, e.g. ranges of what we might consider no effect, trivial, small, moderate, or large effects.CONCLUSION: It is desirable for systematic review authors, guideline panelists, and health technology assessors to specify the threshold or ranges they are using when rating the certainty in evidence.
AB - OBJECTIVE: To clarify the GRADE (grading of recommendations assessment, development and evaluation) definition of certainty of evidence and suggest possible approaches to rating certainty of the evidence for systematic reviews, health technology assessments and guidelines.STUDY DESIGN AND SETTING: This work was carried out by a project group within the GRADE Working Group, through brainstorming and iterative refinement of ideas, using input from workshops, presentations, and discussions at GRADE Working Group meetings to produce this document, which constitutes official GRADE guidance.RESULTS: Certainty of evidence is best considered as the certainty that a true effect lies on one side of a specified threshold, or within a chosen range. We define possible approaches for choosing threshold or range. For guidelines, what we call a fully contextualized approach requires simultaneously considering all critical outcomes and their relative value. Less contextualized approaches, more appropriate for systematic reviews and health technology assessments, include using specified ranges of magnitude of effect, e.g. ranges of what we might consider no effect, trivial, small, moderate, or large effects.CONCLUSION: It is desirable for systematic review authors, guideline panelists, and health technology assessors to specify the threshold or ranges they are using when rating the certainty in evidence.
KW - Journal Article
U2 - 10.1016/j.jclinepi.2017.05.006
DO - 10.1016/j.jclinepi.2017.05.006
M3 - Journal article
C2 - 28529184
SN - 0895-4356
JO - Journal of Clinical Epidemiology
JF - Journal of Clinical Epidemiology
ER -