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Grading quality of evidence and strength of recommendations in clinical practice guidelines
Author(s) -
Brożek J. L.,
Akl E. A.,
AlonsoCoello P.,
Lang D.,
Jaeschke R.,
Williams J. W.,
Phillips B.,
Lelgemann M.,
Lethaby A.,
Bousquet J.,
Guyatt G. H.,
Schünemann H. J.
Publication year - 2009
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1111/j.1398-9995.2009.01973.x
Subject(s) - grading (engineering) , quality of evidence , guideline , medicine , evidence based medicine , psychological intervention , evidence based practice , quality (philosophy) , health care , consistency (knowledge bases) , computer science , alternative medicine , nursing , randomized controlled trial , artificial intelligence , pathology , engineering , philosophy , civil engineering , epistemology , economics , economic growth
The GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) approach provides guidance to grading the quality of underlying evidence and the strength of recommendations in health care. The GRADE system’s conceptual underpinnings allow for a detailed stepwise process that defines what role the quality of the available evidence plays in the development of health care recommendations. The merit of GRADE is not that it eliminates judgments or disagreements about evidence and recommendations, but rather that it makes them transparent. This first article in a three‐part series describes the GRADE framework in relation to grading the quality of evidence about interventions based on examples from the field of allergy and asthma. In the GRADE system, the quality of evidence reflects the extent to which a guideline panel’s confidence in an estimate of the effect is adequate to support a particular recommendation. The system classifies quality of evidence as high, moderate, low, or very low according to factors that include the study methodology, consistency and precision of the results, and directness of the evidence.