Use of GRADE for assessment of evidence about prognosis: rating confidence in estimates of event rates in broad categories of patients

作者：Alfonso Iorio, F.A. Spencer, Maicon Falavigna, Ana Carolina Alba, Eddy Lang, Bernard Burnand, Thomas McGinn, Jill A. Hayden, Katrina Williams, Bev Shea, Robert Wolff, T. Kujpers, Pablo Perel, Per Olav Vandvik, Paul Glasziou, Holger J. Schünemann, Gordon Guyatt · 发表于：BMJ · 年份：2015 · DOI：10.1136/bmj.h870 · 被引用次数：895 · 研究领域：Meta-analysis and systematic reviews、Venous Thromboembolism Diagnosis and Management、Health Systems, Economic Evaluations, Quality of Life

Main concepts : The Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach defines quality of evidence as confidence in effect estimates; this conceptualization can readily be applied to bodies of evidence estimating the risk of future of events (that is, prognosis) in broadly defined populations In the field of prognosis, a body of observational evidence (including single arms of randomized controlled trials) begins as high quality evidence. The five domains GRADE considers in rating down confidence in estimates of treatment effect-that is, risk of bias, imprecision, inconsistency, indirectness, and publication bias-as well as the GRADE criteria for rating up quality, also apply to estimates of the risk of future of events from a body of prognostic studies Applying these concepts to systematic reviews of prognostic studies provides a ful approach to determine confidence in estimates of overall prognosis in broad populations.