GRADE guidelines: 3. Rating the quality of evidence
GRADE guidelines: 3. Rating the quality of evidence
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DOI：
10.1016/j.jclinepi.2010.07.015
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发表时间：
2011-04-01
影响因子：
7.2
通讯作者：
Guyatt, Gordon H.
中科院分区：
文献类型：
--
作者：
Balshem, Howard;Helfand, Mark;Guyatt, Gordon H.
本文介绍了GRADE评价证据质量的方法。GRADE规定了高、中、低和非常低四个类别，适用于大量证据，而不是个别研究。在系统评价的背景下，质量反映了我们对效果估计正确的信心。在建议的上下文中，质量反映了我们对效果估计足以支持特定建议的信心。随机试验开始是高质量的证据，观察性研究是低质量的。GRADE中使用的“质量”不仅仅意味着偏倚风险，因此也可能受到研究结果的不精确性、不一致性、间接性和出版偏倚的影响。此外，有几个因素可以增加我们对效果估计的信心。GRADE提供了一个系统的方法来考虑和报告这些因素。GRADE将评估证据质量的过程与提出建议的过程分开。对建议的力度的判断不仅仅取决于证据的质量。(C)2011 Elsevier Inc. All rights reserved.
This article introduces the approach of GRADE to rating quality of evidence. GRADE specifies four categories high, moderate, low, and very low that are applied to a body of evidence, not to individual studies. In the context of a systematic review, quality reflects our confidence that the estimates of the effect are correct. In the context of recommendations, quality reflects our confidence that the effect estimates are adequate to support a particular recommendation. Randomized trials begin as high-quality evidence, observational studies as low quality. "Quality" as used in GRADE means more than risk of bias and so may also be compromised by imprecision, inconsistency, indirectness of study results, and publication bias. In addition, several factors can increase our confidence in an estimate of effect. GRADE provides a systematic approach for considering and reporting each of these factors. GRADE separates the process of assessing quality of evidence from the process of making recommendations. Judgments about the strength of a recommendation depend on more than just the quality of evidence. (C) 2011 Elsevier Inc. All rights reserved.