Application of GRADE in Systematic Reviews of Diagnostic Accuracy Tests: A Case Analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 YAOLiang ^1,2,3 ^# ,  CHENYao-long ^1,2,3 ^# , DULiang ⁴ , ZENGXian-tao ⁵ , WEIDang ^1,2,3 , WANGQi ^1,2,3 , WANGXiao-qin ^1,2,3 ,  YANGKe-hu ^1,2,3

1. Key Laboratory of Evidence-based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China;
2. Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China;
3. Chinese GRADE Center, Lanzhou University, Lanzhou 730000, China;
4. Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, China;
5. Center for Evidence-based Medicine and Translational Research, Zhongnan Hospital, Wuhan University, Wuhan 430071, China;

Corresponding author：

YANGKe-hu, Email: yangkh@lzu.edu.cn

Keywords：

GRADE; Grading evidence; Systematic review; Diagnostic accuracy test

DOI：

10.7507/1672-2531.20140226

Video：

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The approaches of rating the quality of evidence of systematic reviews of diagnostic accuracy tests are different from systematic reviews of interventional studies. This article systematically introduces the application of GRADE in systematic reviews of diagnostic accuracy tests by a case interpretation and analysis. In this article we present rating workflow in systematic reviews of diagnostic accuracy tests and introduce how to use the GDT website to display the rating results, and interpret the conclusion of systematic reviews based on GRADE results.

Citation： YAOLiang, CHENYao-long, DULiang, ZENGXian-tao, WEIDang, WANGQi, WANGXiao-qin, YANGKe-hu. Application of GRADE in Systematic Reviews of Diagnostic Accuracy Tests: A Case Analysis. Chinese Journal of Evidence-Based Medicine, 2014, 14(11): 1407-1412. doi: 10.7507/1672-2531.20140226 Copy

1.	Shea BJ, Grimshaw JM, Wells GA, et al. Development of AMSTAR:a measurement tool to assess the methodological quality of systematic reviews. BMC Med Res Methodol, 2007, 7:10.
2.	曾宪涛, 黄伟, 田国祥. Meta分析系列之九:Meta分析的质量评价工具.中国循证心血管医学杂志, 2013, 5(1):3-5.
3.	Yao L, Wei D, Wang Q, et al. The correlation analysis of PRISMA, AMSTAR and GRADE in systematic review. 21st Cochrane Colloquium, Abstract Book:61.
4.	陈耀龙, 姚亮, 杜亮, 等. GRADE在诊断准确性试验系统评价中应用的原理、方法、挑战及发展趋势.中国循证医学杂志, 2014, 14(11):.
5.	张晓光, 张小利, 帕丽达, 等.超声造影对乳腺肿块良恶性鉴别诊断价值的系统评价.中国循证医学杂志, 2014, 14(1):79-84.
6.	Gordon H. Guyatt AD. Oxman, GV, et al. GRADE指南:Ⅳ.证据质量分级——研究的局限性(偏倚风险).中国循证医学杂志, 2011, 11(4):456-463.
7.	Whiting PF, Rutjes AW, Westwood ME, et al. QUADAS-2:a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med, 2011, 155(8):529-536.
8.	邬兰, 张永, 曾宪涛. QUADAS-2在诊断准确性研究的质量评价工具中的应用.湖北医药学院学报, 2013, 32(3):201-208.
9.	Whiting P, Rutjes AW, Reitsma JB, et al. The development of QUADAS:a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol, 2003, 3:25.
10.	Oxman D. GRADE指南:Ⅷ.证据质量评价——间接性.中国循证医学杂志, 2012, 11(12):1452-1458.
11.	尤厚成, 刘健, 尤楠, 等.超声造影对乳腺良恶性肿块鉴别诊断的价值.中国普外基础与临床杂志, 2011, 18(8):861-865.
12.	迪丽努尔·买买提明, 尹科, 吕涛, 等.实时超声造影对乳腺良、恶性肿瘤的鉴别诊断价值.新疆医科大学学报, 2011, 34(8):847-849, 854.
13.	陈杰, 吴晓萍, 李旭霞, 等.超声造影和彩色多普勒超声联合检查乳腺肿块的临床价值.医学影像学杂志, 2012, 22(2):286-287.
14.	赵红佳, 董宝玮, 许荣, 等.超声造影定量分析在乳腺肿瘤诊断中的应用价值.中华乳腺病杂志(电子版), 2008, 2(6):634-640.
15.	Guyatt GH, Oxman AD, Kunz R, et al. GRADE指南:Ⅶ.证据质量评价——不一致性.中国循证医学杂志, 2011, 11(12):1444-1451.
16.	Guyatt G, Oxman A D, Kunz R, et al. GRADE指南:Ⅵ.证据质量评价——不精确性(随机误差).中国循证医学杂志, 2011, 11(12):1435-1443.
17.	Flahault A, Cadilhac M, Thomas G. Sample size calculation should be performed for design accuracy in diagnostic test studies. J Clin Epidemiol, 2005, 58(8):859-862.
18.	Guyatt G, Oxman A, Montori V, et al. GRADE指南:Ⅴ.证据质量评价——发表偏倚.中国循证医学杂志, 2011, 11(12):1430-1434.
19.	Van Enst WAl, Ochodo E, Scholten RJ, et al. Investigation of publication bias in meta-analyses of diagnostic test accuracy:a meta-epidemiological study. BMC Med Res Methodol, 2014, 14(1):70.
20.	Chen YL, Yao L, Wang Q, et al. Low scores on AMSTAR may lead to unreliable quality of evidence. 11^th G-I-N conference, 2014.
21.	陈耀龙, 姚亮, 杜亮, 等. GRADE在系统评价中应用的必要性及注意事项.中国循证医学杂志, 2013, 13(12):1401-1404.

1. Shea BJ, Grimshaw JM, Wells GA, et al. Development of AMSTAR:a measurement tool to assess the methodological quality of systematic reviews. BMC Med Res Methodol, 2007, 7:10.
2. 曾宪涛, 黄伟, 田国祥. Meta分析系列之九:Meta分析的质量评价工具.中国循证心血管医学杂志, 2013, 5(1):3-5.
3. Yao L, Wei D, Wang Q, et al. The correlation analysis of PRISMA, AMSTAR and GRADE in systematic review. 21st Cochrane Colloquium, Abstract Book:61.
4. 陈耀龙, 姚亮, 杜亮, 等. GRADE在诊断准确性试验系统评价中应用的原理、方法、挑战及发展趋势.中国循证医学杂志, 2014, 14(11):.
5. 张晓光, 张小利, 帕丽达, 等.超声造影对乳腺肿块良恶性鉴别诊断价值的系统评价.中国循证医学杂志, 2014, 14(1):79-84.
6. Gordon H. Guyatt AD. Oxman, GV, et al. GRADE指南:Ⅳ.证据质量分级——研究的局限性(偏倚风险).中国循证医学杂志, 2011, 11(4):456-463.
7. Whiting PF, Rutjes AW, Westwood ME, et al. QUADAS-2:a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med, 2011, 155(8):529-536.
8. 邬兰, 张永, 曾宪涛. QUADAS-2在诊断准确性研究的质量评价工具中的应用.湖北医药学院学报, 2013, 32(3):201-208.
9. Whiting P, Rutjes AW, Reitsma JB, et al. The development of QUADAS:a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol, 2003, 3:25.
10. Oxman D. GRADE指南:Ⅷ.证据质量评价——间接性.中国循证医学杂志, 2012, 11(12):1452-1458.
11. 尤厚成, 刘健, 尤楠, 等.超声造影对乳腺良恶性肿块鉴别诊断的价值.中国普外基础与临床杂志, 2011, 18(8):861-865.
12. 迪丽努尔·买买提明, 尹科, 吕涛, 等.实时超声造影对乳腺良、恶性肿瘤的鉴别诊断价值.新疆医科大学学报, 2011, 34(8):847-849, 854.
13. 陈杰, 吴晓萍, 李旭霞, 等.超声造影和彩色多普勒超声联合检查乳腺肿块的临床价值.医学影像学杂志, 2012, 22(2):286-287.
14. 赵红佳, 董宝玮, 许荣, 等.超声造影定量分析在乳腺肿瘤诊断中的应用价值.中华乳腺病杂志(电子版), 2008, 2(6):634-640.
15. Guyatt GH, Oxman AD, Kunz R, et al. GRADE指南:Ⅶ.证据质量评价——不一致性.中国循证医学杂志, 2011, 11(12):1444-1451.
16. Guyatt G, Oxman A D, Kunz R, et al. GRADE指南:Ⅵ.证据质量评价——不精确性(随机误差).中国循证医学杂志, 2011, 11(12):1435-1443.
17. Flahault A, Cadilhac M, Thomas G. Sample size calculation should be performed for design accuracy in diagnostic test studies. J Clin Epidemiol, 2005, 58(8):859-862.
18. Guyatt G, Oxman A, Montori V, et al. GRADE指南:Ⅴ.证据质量评价——发表偏倚.中国循证医学杂志, 2011, 11(12):1430-1434.
19. Van Enst WAl, Ochodo E, Scholten RJ, et al. Investigation of publication bias in meta-analyses of diagnostic test accuracy:a meta-epidemiological study. BMC Med Res Methodol, 2014, 14(1):70.
20. Chen YL, Yao L, Wang Q, et al. Low scores on AMSTAR may lead to unreliable quality of evidence. 11^th G-I-N conference, 2014.
21. 陈耀龙, 姚亮, 杜亮, 等. GRADE在系统评价中应用的必要性及注意事项.中国循证医学杂志, 2013, 13(12):1401-1404.

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Chinese Journal of Evidence-Based Medicine

Application of GRADE in Systematic Reviews of Diagnostic Accuracy Tests: A Case Analysis

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