TY - JOUR
T1 - GRADE guidelines 32
T2 - GRADE offers guidance on choosing targets of GRADE certainty of evidence ratings
AU - Zeng, Linan
AU - Brignardello-Petersen, Romina
AU - Hultcrantz, Monica
AU - Siemieniuk, Reed A.C.
AU - Santesso, Nancy
AU - Traversy, Gregory
AU - Izcovich, Ariel
AU - Sadeghirad, Behnam
AU - Alexander, Paul E.
AU - Devji, Tahira
AU - Rochwerg, Bram
AU - Murad, Mohammad H.
AU - Morgan, Rebecca
AU - Christensen, Robin
AU - Schünemann, Holger J.
AU - Guyatt, Gordon H.
N1 - Funding Information:
Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. BS reports receiving funding from PIPRA AG ( www.pipra.ch ) to conduct a systematic review and individual patient data meta-analysis on predictors of post-operative delirium in elderly for 2020-2021. BS also reports funding from Mitacs Canada, accelerate internship in partnership with Nestlé Canada to support his graduate student stipend from 2016 to 2018. Mitacs is a national, not-for-profit organization that has designed and delivered research and training programs in Canada working with universities, companies, and both federal and provincial governments. BS also reports funding from the International Life Sciences Institute (ILSI) - North America to support his graduate work for his 2015 academic year. In 2016-2017, BS worked part-time for the Cornerstone Research Group (CRG), a contract research organization. The ILSI funding and being employed by CRG are outside the required 3-year period requested on ICJME form. TD has received a CIHR knowledge synthesis grant and project grant for work on MIDs for PROMs. RC reported the Parker Institute, Bispebjerg and Frederiksberg Hospital is supported by a core grant from the Oak Foundation (OCAY-18-774-OFIL).
Publisher Copyright:
© 2021 The Author(s)
PY - 2021/9
Y1 - 2021/9
N2 - Objective: To provide practical principles and examples to help GRADE users make optimal choices regarding their ratings of certainty of evidence using a minimally or partially contextualized approach. Study Design and Setting: Based on the GRADE clarification of certainty of evidence in 2017, a project group within the GRADE Working Group conducted iterative discussions and presentations at GRADE Working Group meetings to refine this construct and produce practical guidance. Results: Systematic review and health technology assessment authors need to clarify what it is in which they are rating their certainty of evidence (i.e., the target of their certainty rating). The decision depends on the degree of contextualization (partially or minimally contextualized), thresholds (null, small, moderate or large effect threshold), and where the point estimate lies in relation to the chosen threshold(s). When the 95% confidence interval crosses multiple possible thresholds (i.e., including both large benefit and large harm), it is not worthwhile for authors to determine the target of certainty rating. Conclusion: GRADE provides practical principles to help systematic review and health technology assessment authors specify the target of their certainty of evidence rating.
AB - Objective: To provide practical principles and examples to help GRADE users make optimal choices regarding their ratings of certainty of evidence using a minimally or partially contextualized approach. Study Design and Setting: Based on the GRADE clarification of certainty of evidence in 2017, a project group within the GRADE Working Group conducted iterative discussions and presentations at GRADE Working Group meetings to refine this construct and produce practical guidance. Results: Systematic review and health technology assessment authors need to clarify what it is in which they are rating their certainty of evidence (i.e., the target of their certainty rating). The decision depends on the degree of contextualization (partially or minimally contextualized), thresholds (null, small, moderate or large effect threshold), and where the point estimate lies in relation to the chosen threshold(s). When the 95% confidence interval crosses multiple possible thresholds (i.e., including both large benefit and large harm), it is not worthwhile for authors to determine the target of certainty rating. Conclusion: GRADE provides practical principles to help systematic review and health technology assessment authors specify the target of their certainty of evidence rating.
KW - Evidence-based medicine
KW - GRADE
KW - Health technology assessment
KW - Systematic review
KW - Target of certainty of evidence rating
KW - Thresholds
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U2 - 10.1016/j.jclinepi.2021.03.026
DO - 10.1016/j.jclinepi.2021.03.026
M3 - Article
C2 - 33857619
AN - SCOPUS:85106251712
SN - 0895-4356
VL - 137
SP - 163
EP - 175
JO - Journal of Clinical Epidemiology
JF - Journal of Clinical Epidemiology
ER -