What confidence should we have in GRADE?

Journal of Evaluation in Clinical Practice
Mathew Mercuri, Brian S Baigrie

Abstract

Confidence (or belief) that a therapy is effective is essential to practicing clinical medicine. GRADE, a popular framework for developing clinical recommendations, provides a means for assigning how much confidence one should have in a therapy's effect estimate. One's level of confidence (or "degree of belief") can also be modelled using Bayes theorem. In this paper, we look through both a GRADE and Bayesian lens to examine how one determines confidence in the effect estimate. Philosophical examination. The GRADE framework uses a criteria-based method to assign a quality of evidence level. The criteria pertain mostly to considerations of methodological rigour, derived from a modified evidence-based medicine evidence hierarchy. The four levels of quality relate to the level of confidence one should have in the effect estimate. The Bayesian framework is not bound by a predetermined set of criteria. Bayes theorem shows how a rational agent adjusts confidence (ie, degree of belief) in the effect estimate on the basis of the available evidence. Such adjustments relate to the principles of incremental confirmation and evidence proportionism. Use of the Bayesian framework reveals some potential pitfalls in GRADE's criteria-based thin...Continue Reading

References

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Jan 10, 2018·Journal of Evaluation in Clinical Practice·Mathew MercuriRoss E G Upshur

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Citations

Jul 18, 2018·Journal of Evaluation in Clinical Practice·Mathew Mercuri, Amiram Gafni
Aug 2, 2018·Journal of Evaluation in Clinical Practice·Mathew Mercuri, Amiram Gafni
Aug 31, 2018·Journal of Evaluation in Clinical Practice·Michael LoughlinStephen Buetow
Jul 5, 2019·Journal of Evaluation in Clinical Practice·Mathew Mercuri, Brian S Baigrie
Nov 27, 2020·Journal of Evaluation in Clinical Practice·Robert Mugerauer
Feb 14, 2021·Journal of Evaluation in Clinical Practice·Lucie Perillat, Brian S Baigrie
May 23, 2021·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Christopher R CarpenterJeffrey A Kline
Sep 25, 2021·Advances in Health Sciences Education : Theory and Practice·Aliki ThomasMathew Mercuri

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