GRADE guidelines: 11. Making an overall rating of confidence in effect estimates for a single outcome and for all outcomes

被引：562

作者：

Guyatt, Gordon ^{[1
,2
,11
]}

Oxman, Andrew D. ^{[3
]}

Sultan, Shahnaz ^{[4
]}

Brozek, Jan ^{[5
]}

Glasziou, Paul ^{[6
]}

Alonso-Coello, Pablo ^{[7
]}

Atkins, David ^{[8
]}

Kunz, Regina ^{[9
,10
]}

Montori, Victor ^{[11
]}

Jaeschke, Roman ^{[12
]}

Rind, David ^{[13
]}

Dahm, Philipp ^{[14
]}

Akl, Elie A. ^{[15
]}

Meerpohl, Joerg ^{[16
,17
]}

Vist, Gunn ^{[3
]}

Berliner, Elise ^{[18
]}

Norris, Susan ^{[19
]}

Falck-Ytter, Yngve ^{[19
]}

Schuenemann, Holger J. ^{[2
]}

机构：

[1] McMaster Univ, Dept Clin Epidemiol & Biostat, CLAR Res Grp, Hamilton, ON L8N 3Z5, Canada

[2] McMaster Univ, Dept Med, Hamilton, ON L8N 3Z5, Canada

[3] Norwegian Knowledge Ctr Hlth Serv, N-0130 Oslo, Norway

[4] Univ Florida, Dept Med, Div Gastroenterol Hepatol & Nutr, Gainesville, FL USA

[5] Univ Oxford, Oxford, England

[6] CIBERESP IIB St Pau, Iberoamer Cochrane Ctr, Barcelona 08041, Spain

[7] Dept Vet Affairs, Off Res & Dev, QUERI Program, Washington, DC USA

[8] Univ Basel Hosp, Acad Swiss Insurance Med Asim, CH-4031 Basel, Switzerland

[9] Univ Basel Hosp, Basel Inst Clin Epidemiol, CH-4031 Basel, Switzerland

[10] Mayo Clin, Knowledge & Evaluat Res Unit, Rochester, MN USA

[11] McMaster Univ, Dept Med, Hamilton, ON L8N 3Z5, Canada

[12] Harvard Univ, Sch Med, UpToDate, Boston, MA USA

[13] Univ Florida, Dept Urol, Gainesville, FL USA

[14] SUNY Buffalo, Dept Med, Buffalo, NY 14260 USA

[15] Univ Med Ctr Freiburg, Inst Med Biometry & Med Informat, German Cochrane Ctr, D-79104 Freiburg, Germany

[16] Univ Med Ctr Freiburg, Dept Pediat & Adolescent Med, Div Pediat Hematol & Oncol, D-79106 Freiburg, Germany

[17] Agcy Healthcare Res & Qual, Ctr Outcomes & Evidence, Technol Assessment Program, Rockville, MD 20850 USA

[18] Oregon Hlth & Sci Univ, Dept Med Informat & Clin Epidemiol, Portland, OR 97239 USA

[19] Case Western Reserve Univ, Case & VA Med Ctr, Div Gastroenterol, Cleveland, OH 44106 USA

来源：

JOURNAL OF CLINICAL EPIDEMIOLOGY | 2013年 / 66卷 / 02期

关键词：

GRADE; Quality of evidence; Confidence in estimates; Guideline methodology; Systematic review methodology; Values and preferences; QUALITY; METAANALYSIS;

D O I：

10.1016/j.jclinepi.2012.01.006

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

100404 [儿少卫生与妇幼保健学];

摘要：

GRADE requires guideline developers to make an overall rating of confidence in estimates of effect (quality of evidence high, moderate, low, or very low) for each important or critical outcome. GRADE suggests, for each outcome, the initial separate consideration of five domains of reasons for rating down the confidence in effect estimates, thereby allowing systematic review authors and guideline developers to arrive at an outcome-specific rating of confidence. 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. An overall rating of confidence in estimates of effect is only relevant in settings when recommendations are being made. In general, it is based on the critical outcome that provides the lowest confidence. (C) 2013 Elsevier Inc. All rights reserved.

引用

页码：151 / 157

页数：7

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