GRADE guidelines: 15. Going from evidence to recommendation-determinants of a recommendation's direction and strength

被引：1028

作者：

Andrews, Jeffrey C. ^{[1
]}

Schuenemann, Holger J. ^{[2
,3
]}

Oxman, Andrew D. ^{[4
]}

Pottie, Kevin ^{[5
]}

Meerpohl, Joerg J. ^{[6
,7
]}

Coello, Pablo Alonso ^{[8
,9
]}

Rind, David ^{[10
]}

Montori, Victor M. ^{[11
]}

Brito, Juan Pablo ^{[11
]}

Norris, Susan ^{[12
]}

Elbarbary, Mahmoud ^{[13
]}

Post, Piet ^{[14
]}

Nasser, Mona ^{[15
,16
]}

Shukla, Vijay ^{[17
]}

Jaeschke, Roman ^{[3
]}

Brozek, Jan ^{[2
]}

Djulbegovic, Ben ^{[18
,19
]}

Guyatt, Gordon ^{[2
,3
]}

机构：

[1] Vanderbilt Univ, Vanderbilt Evidence Based Practice Ctr, Nashville, TN 37204 USA

[2] McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON L8N 3Z5, Canada

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

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

[5] Univ Ottawa, Dept Family Med, Ottawa, ON, Canada

[6] Univ Med Ctr Freiburg, German Cochrane Ctr, Inst Med Biometry & Med Informat, D-79110 Freiburg, Germany

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

[8] IIB, Iberoamer Cochrane Ctr, CIBER Epidemiol & Salud Publ, Barcelona 08041, Spain

[9] Hosp Santa Creu & Sant Pau, Epidemiol & Publ Hlth CIBER CIBERESP, Barcelona 08041, Spain

[10] Harvard Univ, Sch Med, Beth Israel Deaconess Med Ctr, Healthcare Associates E Shapiro 6, Boston, MA 02215 USA

[11] Mayo Clin, Rochester, MN 55905 USA

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

[13] King Saud Univ Hlth Sci, Riyadh, Saudi Arabia

[14] Post Voor Zorg, Delft, Netherlands

[15] Univ Exeter, Peninsula Coll Med & Dent, Plymouth PL6 8BU, Devon, England

[16] Univ Plymouth, Peninsula Coll Med & Dent, Plymouth PL6 8BU, Devon, England

[17] CADTH, Ottawa, ON K1S 5S8, Canada

[18] Univ S Florida, Div & Ctr Evidence Based Med & Hlth Outcomes Res, Tampa, FL USA

[19] H Lee Moffitt Canc Ctr & Res Inst, Tampa, FL USA

来源：

JOURNAL OF CLINICAL EPIDEMIOLOGY | 2013年 / 66卷 / 07期

关键词：

GRADE; Quality of evidence; Strength of evidence; Guideline development; Recommendation; Evidence; ESTROGEN PLUS PROGESTIN; NONCARDIAC SURGERY; FINDINGS TABLES; QUALITY; MANAGEMENT; SOCIETY; INFECTION; DISEASE;

D O I：

10.1016/j.jclinepi.2013.02.003

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

In the GRADE approach, the strength of a recommendation reflects the extent to which we can be confident that the composite desirable effects of a management strategy outweigh the composite undesirable effects. This article addresses GRADE's approach to determining the direction and strength of a recommendation. The GRADE 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 undesirable outcomes of interest, confidence in the estimates of effect, estimates of values and preferences, and resource use. Ultimately, guideline panels must use judgment in integrating these factors to make a strong or weak recommendation for or against an intervention. (c) 2013 Elsevier Inc. All rights reserved.

引用

页码：726 / 735

页数：10

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