Journal
JOURNAL OF CLINICAL EPIDEMIOLOGY
Volume 74, Issue -, Pages 19-27Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jclinepi.2015.12.008
Keywords
GRADE; Quality of evidence; Systematic reviews; Health technology assessment; Risk of bias; Summary of findings tables; GRADEpro
Funding
- Cochrane Collaboration's Methods Innovation Fund
- McMaster GRADE Center
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Objectives: The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) working group has developed GRADE evidence profiles (EP) and summary of findings (SoF) tables to present evidence summaries in systematic reviews, clinical guidelines, and health technology assessments. Explanatory notes are used to explain choices and judgments in these summaries, for example, on rating of the quality of evidence. Study Design and Setting: A systematic survey of the explanations in SoF tables in 132 randomly selected Cochrane Intervention reviews and in EPs of 10 guidelines. We analyzed the content of 1,291 explanations using a predefined list of criteria. Results: Most explanations were used to describe or communicate results and to explain downgrading of the quality of evidence, in particular for risk of bias and imprecision. Addressing the source of baseline risk (observational data or control group risk) was often missing. For judgments about downgrading the quality of evidence, the percentage of informative explanations ranged between 41% (imprecision) and 79% (indirectness). Conclusion: We found that by and large explanations were informative but detected several areas for improvement (e.g., source of baseline risk and judgments on imprecision). Guidance about explanatory footnotes and comments will be provided in the last article in this series. (C) 2016 Elsevier Inc. All rights reserved.
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