Improving GRADE evidence tables part 3: detailed guidance for explanatory footnotes supports creating and understanding GRADE certainty in the evidence judgments

Journal of Clinical Epidemiology
Nancy SantessoHolger Schünemann

Abstract

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). 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. Explanations in GRADE evidence tables should be concise, informative, relevant, easy to understand, and accurate. We p...Continue Reading

References

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Citations

Apr 30, 2016·Environment International·Kristina A Thayer, Holger J Schünemann
Jan 30, 2018·The Cochrane Database of Systematic Reviews·Julia SchumannSusanne Unverzagt
Jul 15, 2018·Research Synthesis Methods·Yuan ZhangHolger J Schünemann
Mar 15, 2019·JBI Database of Systematic Reviews and Implementation Reports·Holger J SchünemannJan L Brozek
Mar 30, 2019·The Cochrane Database of Systematic Reviews·James K JewerRonald B George
Jun 7, 2020·Health and Quality of Life Outcomes·Tejan BaldehHolger J Schünemann
Mar 31, 2021·BMJ : British Medical Journal·Matthew J PageJoanne E McKenzie
May 16, 2021·Annals of the Academy of Medicine, Singapore·Saikat MitraKollengode Ramanathan
Jul 14, 2021·Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen·Olesja RisslingLukas Schwingshackl
Jul 31, 2021·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Jürgen L HolleckCraig G Gunderson
Oct 15, 2021·BMJ Open·Joshua G KovoorGuy J Maddern

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