GRADE guidelines: 9. Rating up the quality of evidence.

Overview

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

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:.