GRADE 指南 32：GRADE 为选择 GRADE 证据质量等级的目标提供指导,Journal of Clinical Epidemiology

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GRADE 指南 32：GRADE 为选择 GRADE 证据质量等级的目标提供指导
Journal of Clinical Epidemiology ( IF 7.3 ) Pub Date : 2021-04-20 , DOI: 10.1016/j.jclinepi.2021.03.026
Linan Zeng ₁ , Romina Brignardello-Petersen ₂ , Monica Hultcrantz ₃ , Reed A C Siemieniuk ₂ , Nancy Santesso ₂ , Gregory Traversy ₄ , Ariel Izcovich ₅ , Behnam Sadeghirad ₆ , Paul E Alexander ₂ , Tahira Devji ₂ , Bram Rochwerg ₇ , Mohammad H Murad ₈ , Rebecca Morgan ₂ , Robin Christensen ₉ , Holger J Schünemann ₇ , Gordon H Guyatt ₇

Affiliation

Pharmacy Department/ Evidence-based Pharmacy Centre, West China Second University Hospital, Sichuan University and Key Laboratory of Birth Defects and Related Disease of Women and Children, Ministry of Education, No. 20, Section 3, South Renmin Road, Chengdu, Sichuan, China, 610041; Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, Ontario, Canada, L8S 4L8.
Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, Ontario, Canada, L8S 4L8.
Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU), S:t Eriksgatan 117, SE-102 33, Stockholm, Sweden.
Public Health Agency of Canada. 785 Carling Avenue, Ottawa, Ontario, Canada, K1A 0K9.
Internal Medicine Service, German Hospital, Pueyrred_on 1640, Buenos Aires C1118AAT, Argentina.
Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, Ontario, Canada, L8S 4L8; Department of Anesthesia, McMaster University, 1200 Main Street West Hamilton, Ontario, Canada, L8N 3Z5.
Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, Ontario, Canada, L8S 4L8; Department of Medicine, McMaster University, 1280 Main Street West, Hamilton, Ontario, Canada, L8S 4K1.
Mayo Clinic Evidence-based Practice Center, Mayo Clinic, 200 1st Street SW, Rochester, MN, USA 55905.
Musculoskeletal Statistics Unit, the Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Nordre Fasanvej 57, DK-2000 Copenhagen F, Denmark; Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, J.B. Winsløws Vej 4, 5000 Odense C, Denmark.

客观的

提供实用的原则和示例，以帮助 GRADE 用户使用最低限度或部分背景化的方法就其证据确定性评级做出最佳选择。

研究设计和设置

基于 2017 年 GRADE 对证据确定性的澄清，GRADE 工作组内的一个项目组在 GRADE 工作组会议上进行了迭代讨论和演示，以完善这一结构并产生实用指南。

结果

系统评价和卫生技术评估作者需要澄清他们对证据的确定性（即确定性评分的目标）进行评级的依据是什么。该决定取决于语境化程度（部分或最低限度语境化）、阈值（空、小、中等或大影响阈值）以及点估计与所选阈值相关的位置。当 95% 置信区间跨越多个可能的阈值时（即包括大收益和大伤害），作者确定确定性评级的目标是不值得的。

结论

GRADE 提供了实用的原则，以帮助系统评价和卫生技术评估作者指定其证据确定性评级的目标。

"点击查看英文标题和摘要"

GRADE guidelines 32: GRADE offers guidance on choosing targets of GRADE certainty of evidence ratings

Objective

To provide practical principles and examples to help GRADE users make optimal choices regarding their ratings of certainty of evidence using a minimally or partially contextualized approach.

Study Design and Setting

Based on the GRADE clarification of certainty of evidence in 2017, a project group within the GRADE Working Group conducted iterative discussions and presentations at GRADE Working Group meetings to refine this construct and produce practical guidance.

Results

Systematic review and health technology assessment authors need to clarify what it is in which they are rating their certainty of evidence (i.e., the target of their certainty rating). The decision depends on the degree of contextualization (partially or minimally contextualized), thresholds (null, small, moderate or large effect threshold), and where the point estimate lies in relation to the chosen threshold(s). When the 95% confidence interval crosses multiple possible thresholds (i.e., including both large benefit and large harm), it is not worthwhile for authors to determine the target of certainty rating.

Conclusion

GRADE provides practical principles to help systematic review and health technology assessment authors specify the target of their certainty of evidence rating.

更新日期：2021-05-17

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