Application of GRADE in Systematic Reviews: Necessity, Frequently-Asked Questions and Concerns_Chinese Journal of Evidence-Based Medicine

Authors：

CHEN Yaolong ¹ , YAO Liang ¹ , Susan Norris ² , DU Liang ³ , CHEN Hao ⁴ , ZENG Xiantao ⁵ , MAO Zhi ⁶ ,  YANG Kehu ¹

1. Evidence-Based Medicine Center/Chinese GRADE Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China;2. WHO Guidelines Review Committee Secretariat, Geneva;3. Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, China;4. The Second Medical College, Nanjing University of Chinese Medicine, Nanjing 210046, China;;

Corresponding author：

YANG Kehu, Email: yangkh@lzu.edu.cn

Keywords：

GRADE; Grading Evidence; Systematic review

DOI：

10.7507/1672-2531.20130240

Video：

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We elaborated the reasons why systematic reviews need to use GRADE based on a couple of specific examples. Aiming to provide references to understand and use GRADE correctly, we also answered some frequently-asked questions and concerns about GRADE as follows: a) differentiating the uses of GRADE between its application in guidelines and in systematic reviews; b) how to determine the overall quality of evidence? c) can GRADE be used to access the quality of single study or not? d) different uses of GRADE between randomized controlled trials (RCTs) and observational studies; e) weight of GRADE items; and f) factors that might influence the results of GRADE and the balance between upgrading and downgrading.

Citation： CHEN Yaolong,YAO Liang,Susan Norris,DU Liang,CHEN Hao,ZENG Xiantao,MAO Zhi,YANG Kehu. Application of GRADE in Systematic Reviews: Necessity, Frequently-Asked Questions and Concerns. Chinese Journal of Evidence-Based Medicine, 2013, 13(12): 1401-1404. doi: 10.7507/1672-2531.20130240 Copy

1.	杨克虎. 循证医学. 北京: 人民卫生出版社, 2007.
2.	杨克虎. 系统评价指导手册. 北京: 人民卫生出版社, 2010.
3.	Guyatt GH, Oxman AD, Kunz R, et al. GRADE guidelines 6. Rating the quality of evidence-imprecision. J Clin Epidemiol, 2011, 64(12): 1283-1293.
4.	Pogue JM, Yusuf S. Cumulating evidence from randomized trials: utilizing sequential monitoring boundaries for cumulative meta-analysis. Control Clin Trials, 1997, 18: 580-593.
5.	李远发, 余乔, 於文丽, 等. 霉酚酸酯与环磷酰胺比较治疗狼疮性肾炎的系统评价. 中国循证医学杂志, 2011, 11(7): 826-834.
6.	唐惠林, 栾嵘, 翟所迪. 消化酶制剂治疗消化不良的系统评价. 中国循证医学杂志, 2012, 12(6): 714-721.
7.	赵阳, 王倩, 臧彬. 多巴胺与去甲肾上腺素治疗感染性休克疗效比较的系统评价. 中国循证医学杂志, 2012, 12(6): 679-685.
8.	唐轶洋, 张兴安, 阳婷婷, 等. 舒芬太尼与芬太尼用于术后硬膜外自控镇痛的系统评价. 中国循证医学杂志, 2012, 12(12): 1489-1496.
9.	赵媛, 王燕, 徐旭东, 等. 太极拳运动对老年人平衡功能和跌倒预防效果的Meta分析. 中国循证医学杂志, 2013, 13(3): 339-345.
10.	Balshem H, Helfand M, Schünemann HJ, et al. GRADE guidelines: 3. Rating the quality of evidence. J Clin Epidemiol, 2011, 64(4): 401-406.
11.	Yamey G. Africa’s visionary editor. BMJ, 2003, 327(7419): 832.
12.	Barbour V, Chinnock P, Cohen B, et al. The impact of open access upon public health. Bull World Health Organ, 2006, 84(5): 339.
13.	Guyatt G, Oxman AD, Akl EA, et al. GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol, 2011, 64(4): 383-394.
14.	Guyatt G, Oxman AD, Kunz R, et al. GRADE guidelines: 7. Rating the quality of evidence-inconsistency. J Clin Epidemiol, 2011, 64(4): 383-394.
15.	Guyatt GH, Oxman AD, Kunz R, et al. What is "quality of evidence" and why is it important to clinicians? BMJ, 2008, 336(7651): 995-998.
16.	. 曾宪涛, 冷卫东, 李胜, 等. 如何正确理解及使用GRADE系统. 中国循证医学杂志, 2011, 11(9): 985-990.
17.	Mao Z, Zhang L, Chen Y, et al. GRADE outcomes or studies: how to use the GRADE approach correctly? Int Orthop, 2013, 37(3): 553.
18.	. Savović J, Jones HE, Altman DG, et al. Influence of reported study design characteristics on intervention effect estimates from randomized, controlled trials. Ann Intern Med, 2012, 157(6): 429-438.

1. 杨克虎. 循证医学. 北京: 人民卫生出版社, 2007.
2. 杨克虎. 系统评价指导手册. 北京: 人民卫生出版社, 2010.
3. Guyatt GH, Oxman AD, Kunz R, et al. GRADE guidelines 6. Rating the quality of evidence-imprecision. J Clin Epidemiol, 2011, 64(12): 1283-1293.
4. Pogue JM, Yusuf S. Cumulating evidence from randomized trials: utilizing sequential monitoring boundaries for cumulative meta-analysis. Control Clin Trials, 1997, 18: 580-593.
5. 李远发, 余乔, 於文丽, 等. 霉酚酸酯与环磷酰胺比较治疗狼疮性肾炎的系统评价. 中国循证医学杂志, 2011, 11(7): 826-834.
6. 唐惠林, 栾嵘, 翟所迪. 消化酶制剂治疗消化不良的系统评价. 中国循证医学杂志, 2012, 12(6): 714-721.
7. 赵阳, 王倩, 臧彬. 多巴胺与去甲肾上腺素治疗感染性休克疗效比较的系统评价. 中国循证医学杂志, 2012, 12(6): 679-685.
8. 唐轶洋, 张兴安, 阳婷婷, 等. 舒芬太尼与芬太尼用于术后硬膜外自控镇痛的系统评价. 中国循证医学杂志, 2012, 12(12): 1489-1496.
9. 赵媛, 王燕, 徐旭东, 等. 太极拳运动对老年人平衡功能和跌倒预防效果的Meta分析. 中国循证医学杂志, 2013, 13(3): 339-345.
10. Balshem H, Helfand M, Schünemann HJ, et al. GRADE guidelines: 3. Rating the quality of evidence. J Clin Epidemiol, 2011, 64(4): 401-406.
11. Yamey G. Africa’s visionary editor. BMJ, 2003, 327(7419): 832.
12. Barbour V, Chinnock P, Cohen B, et al. The impact of open access upon public health. Bull World Health Organ, 2006, 84(5): 339.
13. Guyatt G, Oxman AD, Akl EA, et al. GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol, 2011, 64(4): 383-394.
14. Guyatt G, Oxman AD, Kunz R, et al. GRADE guidelines: 7. Rating the quality of evidence-inconsistency. J Clin Epidemiol, 2011, 64(4): 383-394.
15. Guyatt GH, Oxman AD, Kunz R, et al. What is "quality of evidence" and why is it important to clinicians? BMJ, 2008, 336(7651): 995-998.
16. . 曾宪涛, 冷卫东, 李胜, 等. 如何正确理解及使用GRADE系统. 中国循证医学杂志, 2011, 11(9): 985-990.
17. Mao Z, Zhang L, Chen Y, et al. GRADE outcomes or studies: how to use the GRADE approach correctly? Int Orthop, 2013, 37(3): 553.
18. . Savović J, Jones HE, Altman DG, et al. Influence of reported study design characteristics on intervention effect estimates from randomized, controlled trials. Ann Intern Med, 2012, 157(6): 429-438.

Chinese Journal of Evidence-Based Medicine

Application of GRADE in Systematic Reviews: Necessity, Frequently-Asked Questions and Concerns

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