GRADE guidelines: 9. Rating up the quality of evidenceJournal of Clinical Epidemiology
Date of this Version12-1-2011
Document TypeJournal Article
AbstractThe most common reason for rating up the quality of evidence is a large effect. GRADE suggests considering rating up quality of evidence one level when methodologically rigorous observational studies show at least a two-fold reduction or increase in risk, and rating up two levels for at least a five-fold reduction or increase in risk. Systematic review authors and guideline developers may also consider rating up quality of evidence when a dose-response gradient is present, and when all plausible confounders or biases would decrease an apparent treatment effect, or would create a spurious effect when results suggest no effect. Other considerations include the rapidity of the response, the underlying trajectory of the condition, and indirect evidence.
Citation InformationGordon H. Guyatt, Andrew D. Oxman, Shahnaz Sultan, Paul P. Glasziou, et al.. "GRADE guidelines: 9. Rating up the quality of evidence" Journal of Clinical Epidemiology Vol. 64 Iss. 12 (2011) p. 1311 - 1316 ISSN: 0895-4356
Available at: http://works.bepress.com/paul_glasziou/58/