GRADE: An Emerging Consensus on Rating Quality of Evidence and Strength of Recommendations

Schünemann, H., & Santesso, N. (n.d.). Introduction to GRADE. Retrieved from Organization website: https://training.cochrane.org/introduction-grade

Video available Evaluated/validated

Description

This tool provides a transparent way for creating and presenting evidence syntheses. The framework applies a rating of quality of evidence and a grading of strength of recommendations for systematic reviews and clinical practice guidelines. GRADE rates the quality of a body of evidence.

Steps for Using Method/Tool

The GRADE tool guides users through eight criteria for critically assessing the quality of evidence:

  1. Risk of bias/study limitations
  2. Inconsistency of results
  3. Indirectness of evidence
  4. Imprecision
  5. Reporting bias
  6. Magnitude of effect
  7. Dose-response gradient
  8. Direction of plausible biases

Evaluation

Moberg, J., Oxman, A. D., Rosenbaum, S., Schünemann, H. J., Guyatt, G., Flottorp, S., Glenton, C., Lewin, S., Morelli, A., Rada, G., Alonso-Coello, P., & GRADE Working Group (2018). The GRADE vidence to Decision (EtD) framework for health system and public health decisions. Health Research Policy and Systems, 16(1), 45. https://doi.org/10.1186/s12961-018-0320-2

Validity

Neumann, I., Brignardello-Petersen, R., Wiercioch, W., Carrasco-Labra, A., Cuello, C., Akl, E., et al. (2016). The GRADE evidence-to-decision framework: a report of its testing and application in 15 international guideline panels. Implementation Science : IS, 11, 93. https://doi.org/10.1186/s13012-016-0462-y

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