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["Transferability": Is GRADE the solution?]

Marius Goldkuhle1, Tina Jakob1, Nina Kreuzberger1

  • 1Universität zu Köln, Medizinische Fakultät und Uniklinik Köln, Klinik I für Innere Medizin, Evidence-based Oncology.

Zeitschrift Fur Evidenz, Fortbildung Und Qualitat Im Gesundheitswesen
|March 3, 2019
PubMed
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The GRADE approach helps assess evidence certainty for systematic reviews, especially for underrepresented groups. It aids transparent decisions on applying study results to diverse populations, identifying research gaps.

Area of Science:

  • Health Research Methodology
  • Evidence-Based Practice
  • Systematic Reviews and Guidelines

Background:

  • Study results may have limited transferability to populations with different characteristics due to biological and social factors (e.g., age, comorbidities).
  • Subpopulations are often underrepresented in the study landscape, complicating evidence-based decision-making in systematic reviews and guidelines.

Purpose of the Study:

  • To evaluate the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach as a tool for assessing evidence certainty.
  • To enable transparent and evidence-based decisions for systematic reviews and guidelines, particularly for underrepresented subpopulations.
  • To support the explicit handling of applicability and identify research gaps.

Main Methods:

  • The GRADE approach provides a structured methodology for developing precise questions, prioritizing outcomes, and assessing evidence.
Keywords:
GRADEIndirektheitQualitätsbewertungindirectnessquality appraisaltransferabilityÜbertragbarkeit

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  • Evaluation of evidence certainty involves judgments on risk of bias, heterogeneity, directness (including population comparability), precision, and publication bias.
  • GRADE facilitates transparent decisions regarding the applicability of study results from the study population to the target population.

    • Main Results:

    • The GRADE approach is a valid tool for assessing the certainty of evidence.
    • It uncovers gaps in the evidence landscape by demanding transparent decisions about the applicability of study results.
    • While not solving the transferability problem, GRADE supports explicit handling of applicability.

    Conclusions:

    • The GRADE approach is instrumental in enhancing the transparency and evidence base of systematic reviews and clinical guidelines.
    • It aids in identifying and addressing limitations in the transferability of study findings to diverse or underrepresented populations.
    • GRADE can stimulate targeted research to fill identified evidence gaps.