Systems for grading the quality of evidence and the strength of recommendations I: critical appraisal of existing approaches The GRADE Working Group.

2.50
Hdl Handle:
http://hdl.handle.net/10143/38553
Title:
Systems for grading the quality of evidence and the strength of recommendations I: critical appraisal of existing approaches The GRADE Working Group.
Authors:
Atkins, David; Eccles, Martin; Flottorp, Signe; Guyatt, Gordon H; Henry, David; Hill, Suzanne; Liberati, Alessandro; O'Connell, Dianne; Oxman, Andrew David; Phillips, Bob; Schünemann, Holger; Edejer, Tessa Tan-Torres; Vist, Gunn Elisabeth; Williams, John W
Citation:
BMC health services research 2004, 4 (1):38
Additional Links:
http://www.biomedcentral.com/1472-6963/4/38

Full metadata record

DC FieldValue Language
dc.contributor.authorAtkins, David-
dc.contributor.authorEccles, Martin-
dc.contributor.authorFlottorp, Signe-
dc.contributor.authorGuyatt, Gordon H-
dc.contributor.authorHenry, David-
dc.contributor.authorHill, Suzanne-
dc.contributor.authorLiberati, Alessandro-
dc.contributor.authorO'Connell, Dianne-
dc.contributor.authorOxman, Andrew David-
dc.contributor.authorPhillips, Bob-
dc.contributor.authorSchünemann, Holger-
dc.contributor.authorEdejer, Tessa Tan-Torres-
dc.contributor.authorVist, Gunn Elisabeth-
dc.contributor.authorWilliams, John W-
dc.date.accessioned2008-10-04T15:20:56Z-
dc.date.available2008-10-04T15:20:56Z-
dc.date.issued2004-12-22-
dc.identifier.citationBMC health services research 2004, 4 (1):38en
dc.identifier.issn1472-6963-
dc.identifier.pmid15615589-
dc.identifier.doi10.1186/1472-6963-4-38-
dc.identifier.urihttp://hdl.handle.net/10143/38553-
dc.description.abstractBACKGROUND: A number of approaches have been used to grade levels of evidence and the strength of recommendations. The use of many different approaches detracts from one of the main reasons for having explicit approaches: to concisely characterise and communicate this information so that it can easily be understood and thereby help people make well-informed decisions. Our objective was to critically appraise six prominent systems for grading levels of evidence and the strength of recommendations as a basis for agreeing on characteristics of a common, sensible approach to grading levels of evidence and the strength of recommendations. METHODS: Six prominent systems for grading levels of evidence and strength of recommendations were selected and someone familiar with each system prepared a description of each of these. Twelve assessors independently evaluated each system based on twelve criteria to assess the sensibility of the different approaches. Systems used by 51 organisations were compared with these six approaches. RESULTS: There was poor agreement about the sensibility of the six systems. Only one of the systems was suitable for all four types of questions we considered (effectiveness, harm, diagnosis and prognosis). None of the systems was considered usable for all of the target groups we considered (professionals, patients and policy makers). The raters found low reproducibility of judgements made using all six systems. Systems used by 51 organisations that sponsor clinical practice guidelines included a number of minor variations of the six systems that we critically appraised. CONCLUSIONS: All of the currently used approaches to grading levels of evidence and the strength of recommendations have important shortcomings.en
dc.language.isoenen
dc.publisherBioMed Centralen
dc.relation.urlhttp://www.biomedcentral.com/1472-6963/4/38en
dc.subjectVDP::Medisinske Fag: 700::Helsefag: 800::Helsetjeneste- og helseadministrasjonsforskning: 806en
dc.subjectVDP::Medisinske Fag: 700::Helsefag: 800::Samfunnsmedisin, sosialmedisin: 801en
dc.subject.meshAdvisory Committeesen
dc.subject.meshDecision Making, Organizationalen
dc.subject.meshEvidence-Based Medicineen
dc.subject.meshHealth Services Researchen
dc.subject.meshHumansen
dc.subject.meshPractice Guidelines as Topicen
dc.subject.meshQuestionnairesen
dc.subject.meshReproducibility of Resultsen
dc.subject.meshSensitivity and Specificityen
dc.subject.meshSystems Analysisen
dc.subject.meshUnited Statesen
dc.subject.meshUnited States Agency for Healthcare Research and Qualityen
dc.titleSystems for grading the quality of evidence and the strength of recommendations I: critical appraisal of existing approaches The GRADE Working Group.en
dc.typeJournal articleen
dc.typepeer revieweden
dc.typeReviewen
dc.contributor.departmentCenter for Practice and Technology Assessment, Agency for Healthcare Research and Quality, 540 Gaither Rd. Rockville, MD 20852, USA. DAtkins@AHRQ.GOVen
dc.identifier.journalBMC health services researchen
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