GRADE guidelines: 9. Rating up the quality of evidence
GRADE guidelines: 9. Rating up the quality of evidence
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DOI：
10.1016/j.jclinepi.2011.03.017
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发表时间：
2011-12-01
影响因子：
7.2
通讯作者：
Schuenemann, Holger J.
中科院分区：
文献类型：
--
作者：
Guyatt, Gordon H.;Oxman, Andrew D.;Schuenemann, Holger J.
对证据质量进行评级的最常见原因是一个很大的影响。GRADE建议，当严格的方法学观察研究表明风险至少降低或增加两倍时，考虑将证据质量提高一级，并将风险至少降低或增加五倍时，将证据质量提高两级。当存在剂量-反应梯度，当所有看似合理的混杂因素或偏差都会降低明显的治疗效果，或者当结果表明没有效果时，系统综述作者和指南开发人员也可能考虑对证据的质量进行评级。其他考虑因素包括反应的速度、病情的潜在轨迹以及间接证据。(C)2011 Elsevier Inc.保留所有权利。
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. (C) 2011 Elsevier Inc. All rights reserved.