Abstract
Background
The Grading of Recommendations Assessment, Development and Evaluation (GRADE) is widely
used and reliable and accurate for assessing the certainty in the body of health evidence.
The GRADE working group has provided detailed guidance for assessing the certainty
in the body of evidence in systematic reviews and health technology assessments (HTAs)
and how to grade the strength of health recommendations. However, there is limited
advice regarding how to maximize transparency of these judgments, in particular through
explanatory footnotes or explanations in Summary of Findings tables and Evidence Profiles
(GRADE evidence tables).
Methods
We conducted this study to define the essential attributes of useful explanations
and to develop specific guidance for explanations associated with GRADE evidence tables.
We used a sample of explanations according to their complexity, type of judgment involved,
and appropriateness from a database of published GRADE evidence tables in Cochrane
reviews and World Health Organization guidelines. We used an iterative process and
group consensus to determine the attributes and develop guidance.
Results
Explanations in GRADE evidence tables should be concise, informative, relevant, easy
to understand, and accurate. We provide general and domain-specific guidance to assist
authors with achieving these desirable attributes in their explanations associated
with GRADE evidence tables.
Conclusions
Adhering to the general and GRADE domain-specific guidance should improve the quality
of explanations associated with GRADE evidence tables, assist authors of systematic
reviews, HTA reports, or guidelines with information that they can use in other parts
of their evidence synthesis. This guidance will also support editorial evaluation
of evidence syntheses using GRADE and provide a minimum quality standard of judgments
across tables.
Keywords
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Article info
Publication history
Published online: January 12, 2016
Accepted:
December 22,
2015
Footnotes
Conflict of interest: The authors are members of the GRADE working group and/or the Cochrane Collaboration. None of them declared a direct financial conflict of interest.
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
