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GRADE the evidence before using the results in clinical practice
1South Asian Cochrane Network and Centre, Prof BV Moses and ICMR Centre for Advanced Research and Training in Evidence-Informed Healthcare, Christian Medical College, Vellore 632 002, Tamil Nadu, India. prathap@cmcvellore.ac.in
Abstract:
Reports of clinical trials that do not describe the methods used to minimise the risk of bias, and reports that do not present results in a comprehensible and accurate manner, are unethical as they could lead to misleading conclusions, adverse health outcomes, and the inappropriate use of healthcare resources. The Grading of Recommendations: Assessment, Development, and Evaluation (GRADE) approach to framing healthcare recommendations provides a pragmatic approach to making summary evidence profiles of outcome-specific evaluations regarding the magnitude and precision of estimates of benefit and harms, and the overall quality of evidence from comparisons of healthcare interventions. In addition, contextual factors such as the balance between benefits, harms, and resource costs; baseline risks in different groups; inconveniences; varying values and preferences; and competing priorities and options, should ideally be extrapolated from these evidence profiles and other sources of evidence to determine the strength of recommendations regarding the use of an intervention.
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