An algorithm was developed to assign GRADE levels of evidence to comparisons within systematic reviews

Pollock, A., Farmer, S. E., Brady, M. C., Langhorne, P. , Mead, G. E., Mehrholz, J., van Wijck, F. and Wiffen, P. J. (2016) An algorithm was developed to assign GRADE levels of evidence to comparisons within systematic reviews. Journal of Clinical Epidemiology, 70, pp. 106-110. (doi: 10.1016/j.jclinepi.2015.08.013) (PMID:26341023) (PMCID:PMC4742519)

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Abstract

Objectives: One recommended use of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach is supporting quality assessment of evidence of comparisons included within a Cochrane overview of reviews. Within our overview, reviewers found that current GRADE guidance was insufficient to make reliable and consistent judgments. To support our ratings, we developed an algorithm to grade quality of evidence using concrete rules. Methods: Using a pragmatic, exploratory approach, we explored the challenges of applying GRADE levels of evidence and developed an algorithm to applying GRADE levels of evidence in a consistent and transparent approach. Our methods involved application of algorithms and formulas to samples of reviews, expert panel discussion, and iterative refinement and revision. Results: The developed algorithm incorporated four key criteria: number of participants, risk of bias of trials, heterogeneity, and methodological quality of the review. A formula for applying GRADE level of evidence from the number of downgrades assigned by the algorithm was agreed. Conclusion: Our algorithm which assigns GRADE levels of evidence using a set of concrete rules was successfully applied within our Cochrane overview. We propose that this methodological approach has implications for assessment of quality of evidence within future evidence syntheses.

Item Type:Articles
Additional Information:The Cochrane overview was supported by a project grant (CZH/4/854) from the Chief Scientist Office (CSO), part of the Scottish Government Health and Social Care Directorate.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Langhorne, Professor Peter
Authors: Pollock, A., Farmer, S. E., Brady, M. C., Langhorne, P., Mead, G. E., Mehrholz, J., van Wijck, F., and Wiffen, P. J.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:Journal of Clinical Epidemiology
Publisher:Elsevier
ISSN:0895-4356
ISSN (Online):1878-5921
Copyright Holders:Copyright © 2016 The Authors
First Published:First published in Journal of Clinical Epidemiology 70: 106-110
Publisher Policy:Reproduced under a creative commons license

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