The GRADE Working Group clarifies the construct of certainty of evidence
The GRADE Working Group clarifies the construct of certainty of evidence
复制标题
DOI：
10.1016/j.jclinepi.2017.05.006
复制
发表时间：
2017-07-01
影响因子：
7.2
通讯作者：
Guyatt, Gordon
中科院分区：
文献类型：
--
作者：
Hultcrantz, Monica;Rind, David;Guyatt, Gordon
目的：阐明建议评估、发展和评价（GRADE）证据确定性的分级定义，并为系统评价、卫生技术评估和指南提供证据确定性分级的可能方法。研究设计和设置：这项工作是由GRADE工作小组中的一个项目小组进行的，通过头脑风暴和迭代改进想法，使用研讨会、演讲和GRADE工作小组会议上的讨论的输入来产生这份文件，它构成了正式的GRADE指导。结果：证据的确定性最好被认为是真实效果位于指定阈值的一侧或在选定范围内的确定性。我们定义了选择阈值或范围的可能方法。对于指导方针，我们称之为完全情境化的方法需要同时考虑所有关键结果及其相对价值。较少情境化的方法，更适合于系统评价和卫生技术评估，包括使用特定的影响程度范围，例如，我们可能认为没有影响、微不足道、小、中等或大影响的范围。结论：系统评价作者、指南小组成员和卫生技术评估人员在评价证据的确定性时，需要明确他们使用的阈值或范围。(C) 2017年作者。Elsevier Inc.出版。
Objective: To clarify the grading of recommendations assessment, development and evaluation (GRADE) definition of certainty of evidence and suggest possible approaches to rating certainty of the evidence for systematic reviews, health technology assessments, and guidelines.Study Design and Setting: This work was carried out by a project group within the GRADE Working Group, through brainstorming and iterative refinement of ideas, using input from workshops, presentations, and discussions at GRADE Working Group meetings to produce this document, which constitutes official GRADE guidance.Results: Certainty of evidence is best considered as the certainty that a true effect lies on one side of a specified threshold or within a chosen range. We define possible approaches for choosing threshold or range. For guidelines, what we call a fully contextualized approach requires simultaneously considering all critical outcomes and their relative value. Less-contextualized approaches, more appropriate for systematic reviews and health technology assessments, include using specified ranges of magnitude of effect, for example, ranges of what we might consider no effect, trivial, small, moderate, or large effects.Conclusion: It is desirable for systematic review authors, guideline panelists, and health technology assessors to specify the threshold or ranges they are using when rating the certainty in evidence. (C) 2017 The Authors. Published by Elsevier Inc.