The GRADE Working Group clarifies the construct of certainty of evidence
Karolinska Institutet1, Beth Israel Deaconess Medical Center2, American University of Beirut3, University of Aberdeen4, University of Kansas5, McMaster University6, University of Missouri7, Paris Descartes University8, Mayo Clinic9, University of Ottawa10, University of Glasgow11, Malmö University12, Frederiksberg Hospital13, Research Triangle Park14
TL;DR: It is desirable for systematic review authors, guideline panelists, and health technology assessors to specify the threshold or ranges they are using when rating the certainty in evidence.
About: This article is published in Journal of Clinical Epidemiology.The article was published on 2017-07-01 and is currently open access. It has received 409 citations till now.
Citations
More filters
Monash University1, University of Amsterdam2, University of Paris3, Bond University4, University of Texas Health Science Center at San Antonio5, University of Ottawa6, American University of Beirut7, Oregon Health & Science University8, University of York9, Ottawa Hospital Research Institute10, University of Southern Denmark11, Johns Hopkins University12, Brigham and Women's Hospital13, Indiana University14, University of Bristol15, University College London16, University of Toronto17
TL;DR: The preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement as discussed by the authors was designed to help systematic reviewers transparently report why the review was done, what the authors did, and what they found.
Abstract: The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, published in 2009, was designed to help systematic reviewers transparently report why the review was done, what the authors did, and what they found. Over the past decade, advances in systematic review methodology and terminology have necessitated an update to the guideline. The PRISMA 2020 statement replaces the 2009 statement and includes new reporting guidance that reflects advances in methods to identify, select, appraise, and synthesise studies. The structure and presentation of the items have been modified to facilitate implementation. In this article, we present the PRISMA 2020 27-item checklist, an expanded checklist that details reporting recommendations for each item, the PRISMA 2020 abstract checklist, and the revised flow diagrams for original and updated reviews.
16,613 citations
Monash University1, University of Ottawa2, University of Amsterdam3, University of Paris4, Bond University5, University of Texas Health Science Center at San Antonio6, American University of Beirut7, Oregon Health & Science University8, University of York9, Ottawa Hospital Research Institute10, University of Southern Denmark11, Johns Hopkins University12, Brigham and Women's Hospital13, Indiana University14, University of Bristol15, University College London16, University of Toronto17
TL;DR: The preferred reporting items for systematic reviews and meta-analyses (PRISMA 2020) as mentioned in this paper was developed to facilitate transparent and complete reporting of systematic reviews, and has been updated to reflect recent advances in systematic review methodology and terminology.
Abstract: The methods and results of systematic reviews should be reported in sufficient detail to allow users to assess the trustworthiness and applicability of the review findings. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement was developed to facilitate transparent and complete reporting of systematic reviews and has been updated (to PRISMA 2020) to reflect recent advances in systematic review methodology and terminology. Here, we present the explanation and elaboration paper for PRISMA 2020, where we explain why reporting of each item is recommended, present bullet points that detail the reporting recommendations, and present examples from published reviews. We hope that changes to the content and structure of PRISMA 2020 will facilitate uptake of the guideline and lead to more transparent, complete, and accurate reporting of systematic reviews.
2,217 citations
Monash University1, University of Amsterdam2, University of Paris3, Bond University4, University of Texas Health Science Center at San Antonio5, University of Ottawa6, American University of Beirut7, Oregon Health & Science University8, University of York9, Ottawa Hospital Research Institute10, University of Southern Denmark11, Johns Hopkins University12, Brigham and Women's Hospital13, Indiana University14, University of Bristol15, University College London16, University of Toronto17
TL;DR: The preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement as discussed by the authors was designed to help systematic reviewers transparently report why the review was done, what the authors did, and what they found.
Abstract: The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, published in 2009, was designed to help systematic reviewers transparently report why the review was done, what the authors did, and what they found. Over the past decade, advances in systematic review methodology and terminology have necessitated an update to the guideline. The PRISMA 2020 statement replaces the 2009 statement and includes new reporting guidance that reflects advances in methods to identify, select, appraise, and synthesise studies. The structure and presentation of the items have been modified to facilitate implementation. In this article, we present the PRISMA 2020 27-item checklist, an expanded checklist that details reporting recommendations for each item, the PRISMA 2020 abstract checklist, and the revised flow diagrams for original and updated reviews.
2,192 citations
Monash University1, University of Amsterdam2, University of Paris3, Bond University4, University of Texas Health Science Center at San Antonio5, University of Ottawa6, American University of Beirut7, Oregon Health & Science University8, University of York9, Ottawa Hospital Research Institute10, University of Southern Denmark11, Johns Hopkins University12, Brigham and Women's Hospital13, Indiana University14, University of Bristol15, University College London16, University of Toronto17
TL;DR: The preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement as discussed by the authors was designed to help systematic reviewers transparently report why the review was done, what the authors did, and what they found.
1,725 citations
Monash University1, University of Amsterdam2, University of Paris3, Bond University4, University of Texas Health Science Center at San Antonio5, University of Ottawa6, American University of Beirut7, Oregon Health & Science University8, University of York9, Ottawa Hospital Research Institute10, University of Southern Denmark11, Johns Hopkins University12, Brigham and Women's Hospital13, Indiana University14, University of Bristol15, University College London16, University of Toronto17
TL;DR: The PRISMA 2020, an updated reporting guideline for systematic reviews and meta-analyses, was proposed by Page and colleagues as discussed by the authors, who describe the guidelines as "an updated reporting guidelines for systematic review and meta analysis".
Abstract: Matthew Page and co-authors describe PRISMA 2020, an updated reporting guideline for systematic reviews and meta-analyses.
824 citations
References
More filters
TL;DR: The approach of GRADE to rating quality of evidence specifies four categories-high, moderate, low, and very low-that are applied to a body of evidence, not to individual studies.
5,228 citations
"The GRADE Working Group clarifies t..." refers background or methods in this paper
...GRADE offered a formal definition of certainty of evidence: ‘‘the extent of our confidence that the estimates of the effect are correct or are adequate to support a particular decision or recommendation’’ (Box 1) [1]....
[...]
...GRADE writings have recognized this key distinction between practice guidelines and systematic reviews and therefore offered two definitions of certainty in evidence, one for the former setting and one for the latter (Box 1) [1]....
[...]
...Box 1 GRADE’s adopted definition of certainty of the evidence [1]....
[...]
...The grading of recommendations assessment, development and evaluation (GRADE) Working Group has designed a widely adopted structure for the development of clinical practice and public health guidelines [1]....
[...]
McMaster University1, University Hospital of Basel2, Autonomous University of Barcelona3, Harvard University4, Mayo Clinic5, Karolinska University Hospital6, Duke University7, Liverpool School of Tropical Medicine8, Case Western Reserve University9, University Medical Center Freiburg10, Centre for Mental Health11, Vanderbilt University12
TL;DR: It is suggested that examination of 95% confidence intervals (CIs) provides the optimal primary approach to decisions regarding imprecision and rating down the quality of evidence is required if clinical action would differ if the upper versus the lower boundary of the CI represented the truth.
1,844 citations
"The GRADE Working Group clarifies t..." refers background in this paper
...an illustration from previous GRADE writings [2]....
[...]
...Previous GRADE writings have suggested using the optimal information size (OIS) as a possible primary item for rating imprecision [2] (i....
[...]
...An illustration of rating our certainty that the effect lies above a particular threshold in GRADE is in the 6th article of the JCE series that deals with imprecision [2]....
[...]
...This alternative is grounded in the realization that, when deciding whether evidence regarding intervention effects is adequate to support a recommendation, we are not assessing our confidence in point estimates of effects, but rather our confidence in where effects lie relative to particular thresholds [2]....
[...]
Vanderbilt University1, McMaster University2, University of Ottawa3, University Medical Center Freiburg4, Cochrane Collaboration5, Beth Israel Deaconess Medical Center6, Mayo Clinic7, Oregon Health & Science University8, King Saud University9, Peninsula College of Medicine and Dentistry10, Canadian Agency for Drugs and Technologies in Health11, University of South Florida12
TL;DR: This article addresses GRADE's approach to determining the direction and strength of a recommendation, which describes the balance of desirable and undesirable outcomes of interest among alternative management strategies depending on four domains, namely estimates of effect for desirable and desirable outcomes ofinterest, confidence in the estimates ofEffect, estimates of values and preferences, and resource use.
864 citations
"The GRADE Working Group clarifies t..." refers background in this paper
...The values should be those of the patients, and GRADE [8] and others provide guidance regarding how to obtain estimates of those values....
[...]
McMaster University1, Norwegian Institute of Public Health2, University of Florida3, University of Oxford4, United States Department of Veterans Affairs5, University of Basel6, University Hospital of Basel7, Mayo Clinic8, Harvard University9, University at Buffalo10, University of Freiburg11, Agency for Healthcare Research and Quality12, Oregon Health & Science University13, Case Western Reserve University14
TL;DR: Although this rating system represents discrete steps on an ordinal scale, it is helpful to view confidence in estimates as a continuum, and the final rating of confidence may differ from that suggested by separate consideration of each domain.
556 citations
"The GRADE Working Group clarifies t..." refers background in this paper
...This is what GRADE currently refers to as the overall certainty of evidence [7] and thusdpending further conceptual developmentdit provides an interim approximation of certainty in the net benefit....
[...]
TL;DR: Patient values and preferences regarding thromboprophylaxis treatment appear to be highly variable and it should be standard for clinical practice guidelines to conduct systematic reviews of patient values and preference in the specific content area.
241 citations
Additional excerpts
...The process includes a systematic review of the relevant literature [9], the experience of the topic experts in conducting shared decision making, consultation with patients and patient groups, and conduct of targeted surveys [10e12]....
[...]