Assessment of the strength of recommendation and quality of evidence
GRADE checklist. A descriptive study
Keywords:
Evidence-based clinical practice, Systematic review as topic, GRADE approach, Science, Evidence-based medicineAbstract
BACKGROUND: Grading of Recommendations Assessment, Development and Evaluation (GRADE) is a tool for assessing evidence produced in synthesis reports. OBJECTIVES: To present the translation into Portuguese of the GRADE checklist, whose original version is in English, and to describe and explain each topic, in order to provide examples to researchers and professionals who will use the tool. DESIGN AND SETTING: Descriptive study developed at Centro Universitário Tiradentes, Maceió, Alagoas, Brazil.METHODS: This was a translation of the GRADE checklist, with the addition of the Risk Of Bias In Systematic Reviews (ROBIS) tool in the checklist, with examples of its use.RESULTS: Situations of practical use of the tool were presented in order to facilitate and expand the use of assessment of the quality and strength of evidence among Portuguese speakers. CONCLUSIONS: The GRADE checklist is valuable in helping to assess the strength and quality of evidence for synthesis reports for healthcare decision-making.
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References
GRADE. Welcome to the GRADE working group. From evidence to recommendations – transparent and sensible. Available from: http://www.gradeworkinggroup.org Accessed in 2022 (Apr 8).
Guyatt GH, Oxman AD, Kunz R, et al. What is “quality of evidence” and why is it important to clinicians? BMJ. 2008;336(7651):995-8. PMID: 18456631; https://doi.org/10.1136/bmj.39490.551019.BE.
Schünemann H, Brozek J, Guyatt G, Oxman A. GRADE Handbook, Introduction to GRADE Handbook. 2013. Available from: https://gdt.gradepro.org/app/handbook/handbook.html Accessed in 2022 (Apr 8).
Meader N, King L, Llewellyn A, et al. A checklist designed to aid consistency and reproducibility of GRADE assessments: development and pilot validation. Syst Rev. 2014;3:82. PMID: 25056145; https://doi.org/10.1186/2046-4053-3-82.
Guyatt GH. Oxman AD, Vist GE, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336(7650):924-6. PMID: 18436948; https://doi.org/10.1136/bmj.39489.470347.AD.
Brasil. Ministério da Saúde. Secretaria de Ciência, Tecnologia e Insumos Estratégicos. Departamento de Ciência e Tecnologia. Diretrizes metodológicas: Sistema GRADE - Manual de graduação da qualidade da evidência e força de recomendação para tomada de decisão em saúde/Ministério da Saúde, Secretaria de Ciência, Tecnologia e Insumos Estratégicos, Departamento de Ciência e Tecnologia. Brasília: Ministério da Saúde; 2014. Available from: http://bvsms.saude.gov.br/bvs/publicacoes/diretrizes_metodologicas_sistema_grade.pdf Accessed in 2022 (Apr 8).
Boutron I, Page MJ, Higgins JPT, et al. Chapter 7: Considering bias and conflicts of interest among the included studies. In: Higgins JPT, Thomas J, Chandler J, et al., editors. Cochrane Handbook for Systematic Reviews of Interventions version 6.3 (updated February 2022). Cochrane; 2022. Available from: https://training.cochrane.org/handbook/current/chapter-07 Accessed in 2022 (Apr 8).
Higgins JPT, Savović J, Page MJ, Elbers RG, Sterne JAC. Chapter 8: Assessing risk of bias in a randomized trial. In: Higgins JPT, Thomas J, Chandler J, et al., editors. Cochrane Handbook for Systematic Reviews of Interventions version 6.3 (updated February 2022). Cochrane; 2022. Available from: https://training.cochrane.org/handbook/current/chapter-08 Accessed in 2022 (Apr 8).
Guyatt GH, Oxman AD, Vist G, et al. GRADE guidelines: 4. Rating the quality of evidence--study limitations (risk of bias). J Clin Epidemiol. 2011;64(4):407-15. PMID: 21247734; https://doi.org/10.1016/j.jclinepi.2010.07.017.
Guyatt GH, Oxman AD, Montori V, et al. GRADE guidelines: 5. Rating the quality of evidence--publication bias. J Clin Epidemiol. 2011;64(12):1277-82. PMID: 21802904; https://doi.org/10.1016/j.jclinepi.2011.01.011.
Guyatt GH, Oxman AD, Kunz R, et al. GRADE guidelines 6. Rating the quality of evidence--imprecision. J Clin Epidemiol. 2011;64(12):1283-93. PMID: 21839614; https://doi.org/10.1016/j.jclinepi.2011.01.012. Erratum in: J Clin Epidemiol. 2021;137:265.
Guyatt GH, Oxman AD, Kunz R, et al. GRADE guidelines: 7. Rating the quality of evidence--inconsistency. J Clin Epidemiol. 2011;64(12):1294-302. PMID: 21803546; https://doi.org/10.1016/j.jclinepi.2011.03.017.
Guyatt GH, Oxman AD, Kunz R, et al. GRADE guidelines: 8. Rating the quality of evidence--indirectness. J Clin Epidemiol. 2011;64(12)1303-10. PMID: 21802903; https://doi.org/10.1016/j.jclinepi.2011.04.014.
