An algorithm to assign GRADE levels of evidence to comparisons within systematic reviews

Alex Pollock, Sybil E. Farmer, Marian C. Brady, Peter Langhorne, Gillian E. Mead, Jan Mehrholz, Frederike van Wijck, Philip J Wiffen

Research output: Contribution to journalArticle

26 Downloads (Pure)

Abstract

Objectives: One recommended use of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach is supporting quality assessment of evidence of comparisons included within a Cochrane overview of reviews. Within our overview, reviewers found that current GRADE guidance was insufficient to make reliable and consistent judgments. To support our ratings, we developed an algorithm to grade quality of evidence using concrete rules.
Methods: Using a pragmatic, exploratory approach, we explored the challenges of applying GRADE levels of evidence and developed an algorithm to applying GRADE levels of evidence in a consistent and transparent approach. Our methods involved application of algorithms and formulas to samples of reviews, expert panel discussion, and iterative refinement and revision.
Results: The developed algorithm incorporated four key criteria: number of participants, risk of bias of trials, heterogeneity, and methodological
quality of the review. A formula for applying GRADE level of evidence from the number of downgrades assigned by the algorithm was agreed.
Conclusion: Our algorithm which assigns GRADE levels of evidence using a set of concrete rules was successfully applied within our Cochrane overview. We propose that this methodological approach has complications for assessment of quality of evidence within future evidence syntheses.
Original languageEnglish
Pages (from-to)106-110
Number of pages5
JournalJournal of Clinical Epidemiology
Volume70
DOIs
Publication statusPublished - 1 Sep 2015

Keywords

  • GRADE
  • review
  • overview
  • algorithm
  • methodology
  • quality of evidence

Cite this

Pollock, Alex ; Farmer, Sybil E. ; Brady, Marian C. ; Langhorne, Peter ; Mead, Gillian E. ; Mehrholz, Jan ; van Wijck, Frederike ; Wiffen, Philip J. / An algorithm to assign GRADE levels of evidence to comparisons within systematic reviews. In: Journal of Clinical Epidemiology. 2015 ; Vol. 70. pp. 106-110.
@article{52d9ef6ea5f945808b8128348068d30f,
title = "An algorithm to assign GRADE levels of evidence to comparisons within systematic reviews",
abstract = "Objectives: One recommended use of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach is supporting quality assessment of evidence of comparisons included within a Cochrane overview of reviews. Within our overview, reviewers found that current GRADE guidance was insufficient to make reliable and consistent judgments. To support our ratings, we developed an algorithm to grade quality of evidence using concrete rules.Methods: Using a pragmatic, exploratory approach, we explored the challenges of applying GRADE levels of evidence and developed an algorithm to applying GRADE levels of evidence in a consistent and transparent approach. Our methods involved application of algorithms and formulas to samples of reviews, expert panel discussion, and iterative refinement and revision.Results: The developed algorithm incorporated four key criteria: number of participants, risk of bias of trials, heterogeneity, and methodologicalquality of the review. A formula for applying GRADE level of evidence from the number of downgrades assigned by the algorithm was agreed.Conclusion: Our algorithm which assigns GRADE levels of evidence using a set of concrete rules was successfully applied within our Cochrane overview. We propose that this methodological approach has complications for assessment of quality of evidence within future evidence syntheses.",
keywords = "GRADE, review, overview, algorithm, methodology, quality of evidence",
author = "Alex Pollock and Farmer, {Sybil E.} and Brady, {Marian C.} and Peter Langhorne and Mead, {Gillian E.} and Jan Mehrholz and {van Wijck}, Frederike and Wiffen, {Philip J}",
year = "2015",
month = "9",
day = "1",
doi = "10.1016/j.jclinepi.2015.08.013",
language = "English",
volume = "70",
pages = "106--110",
journal = "Journal of Clinical Epidemiology",
issn = "0895-4356",
publisher = "Elsevier B.V.",

}

An algorithm to assign GRADE levels of evidence to comparisons within systematic reviews. / Pollock, Alex; Farmer, Sybil E.; Brady, Marian C.; Langhorne, Peter; Mead, Gillian E.; Mehrholz, Jan; van Wijck, Frederike; Wiffen, Philip J.

In: Journal of Clinical Epidemiology, Vol. 70, 01.09.2015, p. 106-110.

Research output: Contribution to journalArticle

TY - JOUR

T1 - An algorithm to assign GRADE levels of evidence to comparisons within systematic reviews

AU - Pollock, Alex

AU - Farmer, Sybil E.

AU - Brady, Marian C.

AU - Langhorne, Peter

AU - Mead, Gillian E.

AU - Mehrholz, Jan

AU - van Wijck, Frederike

AU - Wiffen, Philip J

PY - 2015/9/1

Y1 - 2015/9/1

N2 - Objectives: One recommended use of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach is supporting quality assessment of evidence of comparisons included within a Cochrane overview of reviews. Within our overview, reviewers found that current GRADE guidance was insufficient to make reliable and consistent judgments. To support our ratings, we developed an algorithm to grade quality of evidence using concrete rules.Methods: Using a pragmatic, exploratory approach, we explored the challenges of applying GRADE levels of evidence and developed an algorithm to applying GRADE levels of evidence in a consistent and transparent approach. Our methods involved application of algorithms and formulas to samples of reviews, expert panel discussion, and iterative refinement and revision.Results: The developed algorithm incorporated four key criteria: number of participants, risk of bias of trials, heterogeneity, and methodologicalquality of the review. A formula for applying GRADE level of evidence from the number of downgrades assigned by the algorithm was agreed.Conclusion: Our algorithm which assigns GRADE levels of evidence using a set of concrete rules was successfully applied within our Cochrane overview. We propose that this methodological approach has complications for assessment of quality of evidence within future evidence syntheses.

AB - Objectives: One recommended use of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach is supporting quality assessment of evidence of comparisons included within a Cochrane overview of reviews. Within our overview, reviewers found that current GRADE guidance was insufficient to make reliable and consistent judgments. To support our ratings, we developed an algorithm to grade quality of evidence using concrete rules.Methods: Using a pragmatic, exploratory approach, we explored the challenges of applying GRADE levels of evidence and developed an algorithm to applying GRADE levels of evidence in a consistent and transparent approach. Our methods involved application of algorithms and formulas to samples of reviews, expert panel discussion, and iterative refinement and revision.Results: The developed algorithm incorporated four key criteria: number of participants, risk of bias of trials, heterogeneity, and methodologicalquality of the review. A formula for applying GRADE level of evidence from the number of downgrades assigned by the algorithm was agreed.Conclusion: Our algorithm which assigns GRADE levels of evidence using a set of concrete rules was successfully applied within our Cochrane overview. We propose that this methodological approach has complications for assessment of quality of evidence within future evidence syntheses.

KW - GRADE

KW - review

KW - overview

KW - algorithm

KW - methodology

KW - quality of evidence

U2 - 10.1016/j.jclinepi.2015.08.013

DO - 10.1016/j.jclinepi.2015.08.013

M3 - Article

VL - 70

SP - 106

EP - 110

JO - Journal of Clinical Epidemiology

JF - Journal of Clinical Epidemiology

SN - 0895-4356

ER -