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|Title:||Grading quality of evidence and strength of recommendations|
|Citation:||British Medical Journal (International Edition), 2004; 328(7454):1490|
|Publisher:||British Med Journal Publ Group|
|Organisation:||Grades of Recommendation Assessment, Development and Evaluation (GRADE) Working Group|
|Abstract:||Users of clinical practice guidelines and other recommendations need to know how much confidence they can place in the recommendations. Systematic and explicit methods of making judgments can reduce errors and improve communication. We have developed a system for grading the quality of evidence and the strength of recommendations that can be applied across a wide range of interventions and contexts. In this article we present a summary of our approach from the perspective of a guideline user. Judgments about the strength of a recommendation require consideration of the balance between benefits and harms, the quality of the evidence, translation of the evidence into specific circumstances, and the certainty of the baseline risk. It is also important to consider costs (resource utilisation) before making a recommendation. Inconsistencies among systems for grading the quality of evidence and the strength of recommendations reduce their potential to facilitate critical appraisal and improve communication of these judgments. Our system for guiding these complex judgments balances the need for simplicity with the need for full and transparent consideration of all important issues.|
|Keywords:||GRADE Working Group; Humans; Evidence-Based Medicine; Cost-Benefit Analysis; Quality Assurance, Health Care; Practice Guidelines as Topic|
|Description:||© 2004 BMJ Publishing Group Ltd.|
|Appears in Collections:||Obstetrics and Gynaecology publications|
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