TY - JOUR
T1 - Improving GRADE evidence tables part 2
T2 - A systematic survey of explanatory notes shows more guidance is needed
AU - Langendam, Miranda
AU - Carrasco-Labra, Alonso
AU - Santesso, Nancy
AU - Mustafa, Reem A.
AU - Brignardello-Petersen, Romina
AU - Ventresca, Matthew
AU - Heus, Pauline
AU - Lasserson, Toby
AU - Moustgaard, Rasmus
AU - Brozek, Jan
AU - Schünemann, Holger J.
PY - 2016/6
Y1 - 2016/6
N2 - Objectives: The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) working group has developed GRADE evidence profiles (EP) and summary of findings (SoF) tables to present evidence summaries in systematic reviews, clinical guidelines, and health technology assessments. Explanatory notes are used to explain choices and judgments in these summaries, for example, on rating of the quality of evidence. Study Design and Setting: A systematic survey of the explanations in SoF tables in 132 randomly selected Cochrane Intervention reviews and in EPs of 10 guidelines. We analyzed the content of 1,291 explanations using a predefined list of criteria. Results: Most explanations were used to describe or communicate results and to explain downgrading of the quality of evidence, in particular for risk of bias and imprecision. Addressing the source of baseline risk (observational data or control group risk) was often missing. For judgments about downgrading the quality of evidence, the percentage of informative explanations ranged between 41% (imprecision) and 79% (indirectness). Conclusion: We found that by and large explanations were informative but detected several areas for improvement (e.g., source of baseline risk and judgments on imprecision). Guidance about explanatory footnotes and comments will be provided in the last article in this series.
AB - Objectives: The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) working group has developed GRADE evidence profiles (EP) and summary of findings (SoF) tables to present evidence summaries in systematic reviews, clinical guidelines, and health technology assessments. Explanatory notes are used to explain choices and judgments in these summaries, for example, on rating of the quality of evidence. Study Design and Setting: A systematic survey of the explanations in SoF tables in 132 randomly selected Cochrane Intervention reviews and in EPs of 10 guidelines. We analyzed the content of 1,291 explanations using a predefined list of criteria. Results: Most explanations were used to describe or communicate results and to explain downgrading of the quality of evidence, in particular for risk of bias and imprecision. Addressing the source of baseline risk (observational data or control group risk) was often missing. For judgments about downgrading the quality of evidence, the percentage of informative explanations ranged between 41% (imprecision) and 79% (indirectness). Conclusion: We found that by and large explanations were informative but detected several areas for improvement (e.g., source of baseline risk and judgments on imprecision). Guidance about explanatory footnotes and comments will be provided in the last article in this series.
KW - GRADE
KW - GRADEpro
KW - Health technology assessment
KW - Quality of evidence
KW - Risk of bias
KW - Summary of findings tables
KW - Systematic reviews
UR - http://www.scopus.com/inward/record.url?scp=84962068671&partnerID=8YFLogxK
U2 - 10.1016/j.jclinepi.2015.12.008
DO - 10.1016/j.jclinepi.2015.12.008
M3 - Article
C2 - 26791431
AN - SCOPUS:84962068671
SN - 0895-4356
VL - 74
SP - 19
EP - 27
JO - Journal of Clinical Epidemiology
JF - Journal of Clinical Epidemiology
ER -