Journal of Clinical Epidemiology
Volume 63, Issue 5 , Pages 513-523 , May 2010

AHRQ Series Paper 5: Grading the strength of a body of evidence when comparing medical interventions—Agency for Healthcare Research and Quality and the Effective Health-Care Program

  • Douglas K. Owens

      Affiliations

    • VA Palo Alto Healthcare System, Palo Alto, CA, 94304 USA
    • Stanford-UCSF Evidence-based Practice Center, Stanford University, Stanford, CA, USA
    • Center for Primary Care and Outcomes Research, Stanford University, Palo Alto, CA, USA
    • Corresponding Author InformationCorresponding author. Center for Primary Care and Outcomes Research, Stanford University, 117 Encina Commons, Stanford, CA 94305-6019, USA. Tel.: 650-723-0933; fax: 650-724-5182.
    • ,
  • Kathleen N. Lohr

      Affiliations

    • RTI International, Research Triangle Park, NC, 27709-2194 USA
    • ,
  • David Atkins

      Affiliations

    • Quality Enhancement Research Initiative, Health Services Research & Development Service (HSR&D), Department of Veterans Affairs, Washington, DC, 20420 USA
    • ,
  • Jonathan R. Treadwell

      Affiliations

    • ECRI Institute Evidence-based Practice Center, Plymouth Meeting, PA, 19462 USA
    • ,
  • James T. Reston

      Affiliations

    • ECRI Institute Evidence-based Practice Center, Plymouth Meeting, PA, 19462 USA
    • ,
  • Eric B. Bass

      Affiliations

    • Johns Hopkins University Evidence-based Practice Center, Baltimore, MD, 21287 USA
    • ,
  • Stephanie Chang

      Affiliations

    • Center for Outcomes and Evidence, Agency for Healthcare Research and Quality, Rockville, MD, 20850 USA
    • ,
  • Mark Helfand

      Affiliations

    • Oregon Health & Sciences University Evidence-based Practice Center, Oregon Health & Sciences University, Staff Physician, Portland VA Medical Center, Portland, OR, 97207 USA

,Accepted 11 March 2009.

References 

  1. Helfand M. Using evidence reports: progress and challenges in evidence-based decision making. Health Aff (Millwood). 2005;24:123–127
  2. Atkins D, Fink K, Slutsky J. Better information for better health care: the Evidence-based Practice Center program and the Agency for Healthcare Research and Quality. Ann Intern Med. 2005;142(12 Pt 2):1035–1041
  3. Helfand M, Balshem H. AHRQ Series Paper 2: Principles for Developing Guidance: AHRQ and the Effective Health-Care Program. J Clin Epidemiol. 2010;63:484–490(In this issue)
  4. Atkins D, Eccles M, Flottorp S, Guyatt GH, Henry D, Hill S, et al. Systems for grading the quality of evidence and the strength of recommendations I: critical appraisal of existing approaches. The GRADE Working Group. BMC Health Serv Res. 2004;4:38
  5. Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336(7650):924–926
  6. Guyatt GH, Oxman AD, Kunz R, Vist GE, Falck-Ytter Y, Schunemann HJ. What is “quality of evidence” and why is it important to clinicians?. BMJ. 2008;336(7651):995–998
  7. West S, King V, Carey TS, Lohr KN, McKoy N, Sutton SF, et al. Systems to Rate the Strength of Scientific Evidence. Evidence Report/Technology Assessment No. 47 (Prepared by the Research Triangle Institute-University of North Carolina Evidence-based Practice Center under Contract No. 290-97-0011). AHRQ Publication No. 02-E016. Rockville, MD: Agency for Healthcare Research and Quality; 2002;
  8. Harris RP, Helfand M, Woolf SH, Lohr KN, Mulrow CD, Teutsch SM, et al. Current methods of the US Preventive Services Task Force: a review of the process. Am J Prev Med. 2001;20(3 Suppl):21–35
  9. Treadwell JR, Tregear SJ, Reston JT, Turkelson CM. A system for rating the stability and strength of medical evidence. BMC Med Res Methodol. 2006;6:52
  10. Furukawa TA, Streiner DL, Hori S. Discrepancies among megatrials. J Clin Epidemiol. 2000;53(12):1193–1199
  11. Charlton BG. Fundamental deficiencies in the megatrial methodology. Curr Control Trials Cardiovasc Med. 2001;2(1):2–7
  12. Langer G, Schloemer G, Knerr A, Kuss O, Behrens J. Nutritional interventions for preventing and treating pressure ulcers. Cochrane Database Syst Rev. 2003;4:CD003216
  13. Sackett DL. Superiority trials, noninferiority trials, and prisoners of the 2-sided null hypothesis. ACP J Club. 2004;140(2):A11
  14. Sackett D. The principles behind the tactics of performing therapeutic trials. In:  Haynes RBS,  Guyatt DL,  Gordon H,  Tugwell P editor. Clinical epidemiology: how to do clinical practice research. New York: Lippincott Williams & Wilkins; 2005;
  15. Gartlehner G, Hansen RA, Nissman D, Lohr KN, Carey TS. A simple and valid tool distinguished efficacy from effectiveness studies. J Clin Epidemiol. 2006;59:1040–1048

PII: S0895-4356(09)00093-6

doi: 10.1016/j.jclinepi.2009.03.009

Journal of Clinical Epidemiology
Volume 63, Issue 5 , Pages 513-523 , May 2010

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