GRADE guidelines: 11. Making an overall rating of confidence in effect estimates for a single outcome and for all outcomes
Por:
Guyatt, G, Oxman, AD, Sultan, S, Brozek, J, Glasziou, P, Alonso-Coello, P, Atkins, D, Kunz, R, Montori, V, Jaeschke, R, Rind, D, Dahm, P, Akl, EA, Meerpohl, J, Vist, G, Berliner, E, Norris, S, Falck-Ytter, Y, Schunemann, HJ
Publicada:
1 feb 2013
Resumen:
GRADE requires guideline developers to make an overall rating of confidence in estimates of effect (quality of evidence high, moderate, low, or very low) for each important or critical outcome. GRADE suggests, for each outcome, the initial separate consideration of five domains of reasons for rating down the confidence in effect estimates, thereby allowing systematic review authors and guideline developers to arrive at an outcome-specific rating of confidence. Although this rating system represents discrete steps on an ordinal scale, it is helpful to view confidence in estimates as a continuum, and the final rating of confidence may differ from that suggested by separate consideration of each domain.
An overall rating of confidence in estimates of effect is only relevant in settings when recommendations are being made. In general, it is based on the critical outcome that provides the lowest confidence. (C) 2013 Elsevier Inc. All rights reserved.
Filiaciones:
Guyatt, G:
McMaster Univ, Dept Clin Epidemiol & Biostat, CLAR Res Grp, Hamilton, ON L8N 3Z5, Canada
McMaster Univ, Dept Med, Hamilton, ON L8N 3Z5, Canada
Oxman, AD:
Norwegian Knowledge Ctr Hlth Serv, N-0130 Oslo, Norway
Sultan, S:
Univ Florida, Dept Med, Div Gastroenterol Hepatol & Nutr, Gainesville, FL USA
Brozek, J:
Univ Oxford, Oxford, England
Glasziou, P:
CIBERESP IIB St Pau, Iberoamer Cochrane Ctr, Barcelona 08041, Spain
Alonso-Coello, P:
CIBERESP IIB St Pau, Iberoamer Cochrane Ctr, Barcelona 08041, Spain
Atkins, D:
Univ Basel Hosp, Acad Swiss Insurance Med Asim, CH-4031 Basel, Switzerland
Kunz, R:
Univ Basel Hosp, Basel Inst Clin Epidemiol, CH-4031 Basel, Switzerland
Mayo Clin, Knowledge & Evaluat Res Unit, Rochester, MN USA
Montori, V:
McMaster Univ, Dept Med, Hamilton, ON L8N 3Z5, Canada
Jaeschke, R:
Harvard Univ, Sch Med, UpToDate, Boston, MA USA
Rind, D:
Univ Florida, Dept Urol, Gainesville, FL USA
Dahm, P:
SUNY Buffalo, Dept Med, Buffalo, NY 14260 USA
Akl, EA:
Univ Med Ctr Freiburg, Inst Med Biometry & Med Informat, German Cochrane Ctr, D-79104 Freiburg, Germany
Meerpohl, J:
Univ Med Ctr Freiburg, Dept Pediat & Adolescent Med, Div Pediat Hematol & Oncol, D-79106 Freiburg, Germany
Agcy Healthcare Res & Qual, Ctr Outcomes & Evidence, Technol Assessment Program, Rockville, MD 20850 USA
Vist, G:
Norwegian Knowledge Ctr Hlth Serv, N-0130 Oslo, Norway
Berliner, E:
Oregon Hlth & Sci Univ, Dept Med Informat & Clin Epidemiol, Portland, OR 97239 USA
Norris, S:
Case Western Reserve Univ, Case & VA Med Ctr, Div Gastroenterol, Cleveland, OH 44106 USA
Falck-Ytter, Y:
Case Western Reserve Univ, Case & VA Med Ctr, Div Gastroenterol, Cleveland, OH 44106 USA
Schunemann, HJ:
McMaster Univ, Dept Med, Hamilton, ON L8N 3Z5, Canada
Dept Vet Affairs, Off Res & Dev, QUERI Program, Washington, DC USA
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