GRADE guidelines: 9. Rating up the quality of evidence.
- Overview
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- Title:
- GRADE guidelines: 9. Rating up the quality of evidence.
- Authors:
- Guyatt GH, Oxman AD, Sultan S, Glasziou P, Akl EA, Alonso-Coello P, Atkins D, Kunz R, Brozek J, Montori V, Jaeschke R, Rind D, Dahm P, Meerpohl J, Vist G, Berliner E, Norris S, Falck-Ytter Y, Murad MH, Schünemann HJ, The GRADE Working Group
- Journal:
- J Clin Epidemiol.
- Publication date:
- 2011 Jul 29
- Volume:
- Epub ahead of print
- Link to pubmed:
- http://www.ncbi.nlm.nih.gov/pubmed/21802902
- Publication type:
- Journal
- Abstract
- The most common reason for rating up the quality of evidence is a large effect. GRADE suggests considering rating up quality of evidence one level when methodologically rigorous observational studies show at least a two-fold reduction or increase in risk, and rating up two levels for at least a five-fold reduction or increase in risk. Systematic review authors and guideline developers may also consider rating up quality of evidence when a dose-response gradient is present, and when all plausible confounders or biases would decrease an apparent treatment effect, or would create a spurious effect when results suggest no effect. Other considerations include the rapidity of the response, the underlying trajectory of the condition, and indirect evidence.
- Preview
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GRADE guidelines: 9. Rating up the quality of evidence. Guyatt GH, Oxman AD, Sultan S, Glasziou P, Akl EA, Alonso-Coello P et al. J Clin Epidemiol. 2011 Jul 29; Epub ahead of print:.