GRADE guidelines 32: GRADE offers guidance on choosing targets of GRADE certainty of evidence ratings

被引：164

作者：

Zeng, Linan ^{[1
,2
,3
]}

Brignardello-Petersen, Romina ^{[3
]}

Hultcrantz, Monica ^{[4
]}

Siemieniuk, Reed A. C. ^{[3
]}

Santesso, Nancy ^{[3
]}

Traversy, Gregory ^{[5
]}

Izcovich, Ariel ^{[6
]}

Sadeghirad, Behnam ^{[3
,7
]}

Alexander, Paul E. ^{[3
]}

Devji, Tahira ^{[3
]}

Rochwerg, Bram ^{[3
,8
]}

Murad, Mohammad H. ^{[9
]}

Morgan, Rebecca ^{[3
]}

Christensen, Robin ^{[10
,11
]}

Schunemann, Holger J. ^{[3
,8
]}

Guyatt, Gordon H. ^{[3
,8
]}

机构：

[1] Sichuan Univ, Pharm Dept, Evidence Based Pharm Ctr, West China Univ Hosp 2, 20,Sect 3,South Renmin Rd, Chengdu 610041, Sichuan, Peoples R China

[2] Key Lab Birth Defects & Related Dis Women & Child, Minist Educ, 20,Sect 3,South Renmin Rd, Chengdu 610041, Sichuan, Peoples R China

[3] McMaster Univ, Dept Hlth Res Methods Evidence & Impact, 1280 Main St West, Hamilton, ON L8S 4L8, Canada

[4] Swedish Agcy Hlth Technol Assessment & Assessment, St Eriksgatan 117, SE-10233 Stockholm, Sweden

[5] Publ Hlth Agcy Canada, 785 Carling Ave, Ottawa, ON, Canada

[6] German Hosp, Internal Med Serv, Pueyrred 1640,C1118AAT, Buenos Aires, DF, Argentina

[7] McMaster Univ, Dept Anesthesia, 1200 Main St West Hamilton, Hamilton, ON L8N 3Z5, Canada

[8] McMaster Univ, Dept Med, 1280 Main St West, Hamilton, ON L8S 4K1, Canada

[9] Mayo Clin Evidence Based Practice Ctr, Mayo Clin, 200,1st St SW, Rochester, MN 55905 USA

[10] Univ Copenhagen, Parker Inst, Bispebjerg & Frederiksberg Hosp, Musculoskeletal Stat Unit, Nordre Fasanvej 57, DK-2000 Copenhagen F, Denmark

[11] Univ Southern Denmark, Odense Univ Hosp, Dept Clin Res, Rheumatol Res Unit, JB Winslows Vej 4, DK-5000 Odense, Denmark

来源：

JOURNAL OF CLINICAL EPIDEMIOLOGY | 2021年 / 137卷

关键词：

GRADE; Target of certainty of evidence rating; Thresholds; Evidence-based medicine; Systematic review; Health technology assessment;

D O I：

10.1016/j.jclinepi.2021.03.026

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Objective: To provide practical principles and examples to help GRADE users make optimal choices regarding their ratings of certainty of evidence using a minimally or partially contextualized approach. Study Design and Setting: Based on the GRADE clarification of certainty of evidence in 2017, a project group within the GRADE Working Group conducted iterative discussions and presentations at GRADE Working Group meetings to refine this construct and produce practical guidance. Results: Systematic review and health technology assessment authors need to clarify what it is in which they are rating their certainty of evidence (i.e., the target of their certainty rating). The decision depends on the degree of contextualization (partially or minimally contextualized), thresholds (null, small, moderate or large effect threshold), and where the point estimate lies in relation to the chosen threshold(s). When the 95% confidence interval crosses multiple possible thresholds (i.e., including both large benefit and large harm), it is not worthwhile for authors to determine the target of certainty rating. Conclusion: GRADE provides practical principles to help systematic review and health technology assessment authors specify the target of their certainty of evidence rating. (c) 2021 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license ( http:// creativecommons.org/ licenses/ by- nc-nd/ 4.0/ )

引用

页码：163 / 175

页数：13

共 9 条

[1] Defining certainty of net benefit: a GRADE concept paper [J].