The predictive validity of quality of evidence grades for the stability of effect estimates was low: a meta-epidemiological study

Journal of Clinical Epidemiology
Gerald GartlehnerKathleen N Lohr

Abstract

To determine the predictive validity of the U.S. Evidence-based Practice Center (EPC) approach to GRADE (Grading of Recommendations Assessment, Development and Evaluation). Based on Cochrane reports with outcomes graded as high quality of evidence (QOE), we prepared 160 documents which represented different levels of QOE. Professional systematic reviewers dually graded the QOE. For each document, we determined whether estimates were concordant with high QOE estimates of the Cochrane reports. We compared the observed proportion of concordant estimates with the expected proportion from an international survey. To determine the predictive validity, we used the Hosmer-Lemeshow test to assess calibration and the C (concordance) index to assess discrimination. The predictive validity of the EPC approach to GRADE was limited. Estimates graded as high QOE were less likely, estimates graded as low or insufficient QOE more likely to remain stable than expected. The EPC approach to GRADE could not reliably predict the likelihood that individual bodies of evidence remain stable as new evidence becomes available. C-indices ranged between 0.56 (95% CI, 0.47 to 0.66) and 0.58 (95% CI, 0.50 to 0.67) indicating a low discriminatory ability. The...Continue Reading

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Dec 9, 2014·Journal of Clinical Epidemiology·Gerald GartlehnerKathleen N Lohr

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Citations

Nov 1, 2017·American Journal of Respiratory and Critical Care Medicine·Noah C Schoenberg, Kevin C Wilson
Apr 27, 2018·Thyroid : Official Journal of the American Thyroid Association·Anna M SawkaJacqueline Jonklaas
Jan 19, 2018·American Journal of Respiratory and Critical Care Medicine·Holger J Schünemann, Jan L Brożek
Jan 19, 2018·American Journal of Respiratory and Critical Care Medicine·Noah C SchoenbergUNKNOWN all authors
Feb 21, 2018·Anesthesia and Analgesia·Mark E Nunnally, Avery Tung
Jul 22, 2017·American Journal of Respiratory and Critical Care Medicine·Noah C SchoenbergKevin C Wilson
Aug 9, 2017·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Jeffrey I MechanickSikarin Upala

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