Cited by 260Meta-analysis and systematic reviewsClinical practice guidelines implementationDelphi Technique in Research

Using systematic reviews in guideline development: The GRADE approach

Zhang, Yuan, Akl, Elie A., Schünemann, Holger J.·2019·Research Synthesis Methods

Abstract

Systematic reviews are essential to produce trustworthy guidelines. To assess the certainty of a body of evidence included in a systematic review, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group has developed an approach that is currently used by over 100 organizations, including the World Health Organization and the Cochrane Collaboration. GRADE provides operational definitions and instructions to rate the certainty of the evidence for each outcome in a review as high, moderate, low, or very low for the effects of interventions, prognostic estimates, values and preferences, test accuracy, and resource utilization. The assessment includes assessing risk of bias, imprecision, inconsistency, indirectness, and publication bias, the magnitude of effects, dose‐response relations, and the impact of residual confounding and bias. Summary statistical information and assessments of certainty are presented in GRADE evidence summary tables, which can be produced using GRADE's official GRADEpro software tool ( www.gradepro.org /). The evidence summary tables feed into the GRADE Evidence to Decision frameworks which guideline panels can use to produce recommendations.

Integrity signals

Registry

Crossref · 10.1002/jrsm.1313

Cites

67 of 67 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Authors
Zhang, Y., Akl, E. A., & Schünemann, H. J.
Affiliations
McMaster University (CA)
Corresponding author
Schünemann, Holger J.
Venue
Research Synthesis Methods
Publisher
Wiley
Published
2018-09-25
Volume
10
Issue
3
Pages
312-329
ISSN
  • 1759-2879 (ISSN-L)
  • 1759-2887
OpenAlex
W2884972765
Cited by
260
References
67
Citations by year
2026: 38 · 2025: 51 · 2024: 44 · 2023: 42 · 2022: 31 · 2021: 29 · 2020: 13 · 2019: 10 · 2016: 1
FWCI
2.58
Type
journal article
Language
en
Open access
closed
Locations
  • Research Synthesis Methods (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
  • Social Sciences › Sociology and Political Science › Delphi Technique in Research
Keywords
GRADE, quality of evidence, systematic reviews, clinical guideline development, risk of bias, imprecision, inconsistency, indirectness, publication bias, dose-response relationship, residual confounding, evidence-to-decision framework

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review