GRADE guidelines: 15. Going from evidence to recommendation - Determinants of a recommendation's direction and strength

Jeffrey C. Andrews, Holger J. Schünemann, Andrew D. Oxman, Kevin Pottie, Joerg J. Meerpohl, Pablo Alonso Coello, David Rind, Victor Manuel Montori, Juan Brito Campana, Susan Norris, Mahmoud Elbarbary, Piet Post, Mona Nasser, Vijay Shukla, Roman Jaeschke, Jan Brozek, Ben Djulbegovic, Gordon Guyatt

Research output: Contribution to journalArticle

426 Citations (Scopus)

Abstract

In the GRADE approach, the strength of a recommendation reflects the extent to which we can be confident that the composite desirable effects of a management strategy outweigh the composite undesirable effects. This article addresses GRADE's approach to determining the direction and strength of a recommendation. The GRADE describes the balance of desirable and undesirable outcomes of interest among alternative management strategies depending on four domains, namely estimates of effect for desirable and undesirable outcomes of interest, confidence in the estimates of effect, estimates of values and preferences, and resource use. Ultimately, guideline panels must use judgment in integrating these factors to make a strong or weak recommendation for or against an intervention.

Original languageEnglish (US)
Pages (from-to)726-735
Number of pages10
JournalJournal of Clinical Epidemiology
Volume66
Issue number7
DOIs
StatePublished - Jul 2013

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Keywords

  • Evidence
  • GRADE
  • Guideline development
  • Quality of evidence
  • Recommendation
  • Strength of evidence

ASJC Scopus subject areas

  • Epidemiology

Cite this

Andrews, J. C., Schünemann, H. J., Oxman, A. D., Pottie, K., Meerpohl, J. J., Coello, P. A., ... Guyatt, G. (2013). GRADE guidelines: 15. Going from evidence to recommendation - Determinants of a recommendation's direction and strength. Journal of Clinical Epidemiology, 66(7), 726-735. https://doi.org/10.1016/j.jclinepi.2013.02.003

GRADE guidelines : 15. Going from evidence to recommendation - Determinants of a recommendation's direction and strength. / Andrews, Jeffrey C.; Schünemann, Holger J.; Oxman, Andrew D.; Pottie, Kevin; Meerpohl, Joerg J.; Coello, Pablo Alonso; Rind, David; Montori, Victor Manuel; Brito Campana, Juan; Norris, Susan; Elbarbary, Mahmoud; Post, Piet; Nasser, Mona; Shukla, Vijay; Jaeschke, Roman; Brozek, Jan; Djulbegovic, Ben; Guyatt, Gordon.

In: Journal of Clinical Epidemiology, Vol. 66, No. 7, 07.2013, p. 726-735.

Research output: Contribution to journalArticle

Andrews, JC, Schünemann, HJ, Oxman, AD, Pottie, K, Meerpohl, JJ, Coello, PA, Rind, D, Montori, VM, Brito Campana, J, Norris, S, Elbarbary, M, Post, P, Nasser, M, Shukla, V, Jaeschke, R, Brozek, J, Djulbegovic, B & Guyatt, G 2013, 'GRADE guidelines: 15. Going from evidence to recommendation - Determinants of a recommendation's direction and strength', Journal of Clinical Epidemiology, vol. 66, no. 7, pp. 726-735. https://doi.org/10.1016/j.jclinepi.2013.02.003
Andrews, Jeffrey C. ; Schünemann, Holger J. ; Oxman, Andrew D. ; Pottie, Kevin ; Meerpohl, Joerg J. ; Coello, Pablo Alonso ; Rind, David ; Montori, Victor Manuel ; Brito Campana, Juan ; Norris, Susan ; Elbarbary, Mahmoud ; Post, Piet ; Nasser, Mona ; Shukla, Vijay ; Jaeschke, Roman ; Brozek, Jan ; Djulbegovic, Ben ; Guyatt, Gordon. / GRADE guidelines : 15. Going from evidence to recommendation - Determinants of a recommendation's direction and strength. In: Journal of Clinical Epidemiology. 2013 ; Vol. 66, No. 7. pp. 726-735.
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