GRADE guidelines: 15. Going from evidence to recommendation - Determinants of a recommendation's direction and strength

Jeffrey C. Andrews; Holger J. Schünemann; Andrew D. Oxman; Kevin Pottie; Joerg J. Meerpohl; Pablo Alonso Coello; David Rind; Victor M. Montori; Juan Pablo Brito; Susan Norris; Mahmoud Elbarbary; Piet Post; Mona Nasser; Vijay Shukla; Roman Jaeschke; Jan Brozek; Ben Djulbegovic; Gordon Guyatt

doi:10.1016/j.jclinepi.2013.02.003

GRADE guidelines: 15. Going from evidence to recommendation - Determinants of a recommendation's direction and strength

Jeffrey C. Andrews, Holger J. Schünemann, Andrew D. Oxman, Kevin Pottie, Joerg J. Meerpohl, Pablo Alonso Coello, David Rind, Victor M. Montori, Juan Pablo Brito, Susan Norris, Mahmoud Elbarbary, Piet Post, Mona Nasser, Vijay Shukla, Roman Jaeschke, Jan Brozek, Ben Djulbegovic, Gordon Guyatt

Research output: Contribution to journal › Article › peer-review

558 Scopus citations

Abstract

In the GRADE approach, the strength of a recommendation reflects the extent to which we can be confident that the composite desirable effects of a management strategy outweigh the composite undesirable effects. This article addresses GRADE's approach to determining the direction and strength of a recommendation. The GRADE describes the balance of desirable and undesirable outcomes of interest among alternative management strategies depending on four domains, namely estimates of effect for desirable and undesirable outcomes of interest, confidence in the estimates of effect, estimates of values and preferences, and resource use. Ultimately, guideline panels must use judgment in integrating these factors to make a strong or weak recommendation for or against an intervention.

Original language	English (US)
Pages (from-to)	726-735
Number of pages	10
Journal	Journal of Clinical Epidemiology
Volume	66
Issue number	7
DOIs	https://doi.org/10.1016/j.jclinepi.2013.02.003
State	Published - Jul 2013

Keywords

Evidence
GRADE
Guideline development
Quality of evidence
Recommendation
Strength of evidence

ASJC Scopus subject areas

Epidemiology

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10.1016/j.jclinepi.2013.02.003

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Andrews, J. C., Schünemann, H. J., Oxman, A. D., Pottie, K., Meerpohl, J. J., Coello, P. A., Rind, D., Montori, V. M., Brito, J. P., Norris, S., Elbarbary, M., Post, P., Nasser, M., Shukla, V., Jaeschke, R., Brozek, J., Djulbegovic, B., & Guyatt, G. (2013). GRADE guidelines: 15. Going from evidence to recommendation - Determinants of a recommendation's direction and strength. Journal of Clinical Epidemiology, 66(7), 726-735. https://doi.org/10.1016/j.jclinepi.2013.02.003

Andrews, JC, Schünemann, HJ, Oxman, AD, Pottie, K, Meerpohl, JJ, Coello, PA, Rind, D, Montori, VM , Brito, JP, Norris, S, Elbarbary, M, Post, P, Nasser, M, Shukla, V, Jaeschke, R, Brozek, J, Djulbegovic, B & Guyatt, G 2013, 'GRADE guidelines: 15. Going from evidence to recommendation - Determinants of a recommendation's direction and strength', Journal of Clinical Epidemiology, vol. 66, no. 7, pp. 726-735. https://doi.org/10.1016/j.jclinepi.2013.02.003

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abstract = "In the GRADE approach, the strength of a recommendation reflects the extent to which we can be confident that the composite desirable effects of a management strategy outweigh the composite undesirable effects. This article addresses GRADE's approach to determining the direction and strength of a recommendation. The GRADE describes the balance of desirable and undesirable outcomes of interest among alternative management strategies depending on four domains, namely estimates of effect for desirable and undesirable outcomes of interest, confidence in the estimates of effect, estimates of values and preferences, and resource use. Ultimately, guideline panels must use judgment in integrating these factors to make a strong or weak recommendation for or against an intervention.",

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AU - Rind, David

AU - Montori, Victor M.

AU - Brito, Juan Pablo

AU - Norris, Susan

AU - Elbarbary, Mahmoud

AU - Post, Piet

AU - Nasser, Mona

AU - Shukla, Vijay

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KW - Recommendation

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GRADE guidelines: 15. Going from evidence to recommendation - Determinants of a recommendation's direction and strength

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Keywords

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