GRADE guidelines: 13. Preparing Summary of Findings tables and evidence profiles—continuous outcomes
Abstract
Presenting continuous outcomes in Summary of Findings tables presents particular challenges to interpretation. When each study uses the same outcome measure, and the units of that measure are intuitively interpretable (e.g., duration of hospitalization, duration of symptoms), presenting differences in means is usually desirable. When the natural units of the outcome measure are not easily interpretable, choosing a threshold to create a binary outcome and presenting relative and absolute effects become a more attractive alternative. When studies use different measures of the same construct, calculating summary measures requires converting to the same units of measurement for each study. The longest standing and most widely used approach is to divide the difference in means in each study by its standard deviation and present pooled results in standard deviation units (standardized mean difference). Disadvantages of this approach include vulnerability to varying degrees of heterogeneity in the underlying populations and difficulties in interpretation. Alternatives include presenting results in the units of the most popular or interpretable measure, converting to dichotomous measures and presenting relative and absolute effects, presenting the ratio of the means of intervention and control groups, and presenting the results in minimally important difference units. We outline the merits and limitations of each alternative and provide guidance for meta-analysts and guideline developers.
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The review attempted to translate SMD data into changes on widely used scales (Guyatt 2013), but was unable to apply any of the methods without introducing further bias because of the variety of scales and wide range of baseline scores.
“We attempted to translate SMD data into changes on widely used scales (Guyatt 2013), but we were unable to apply any of the methods without introducing further bias because of the variety of scales and wide range of baseline scores.”
From Psychological therapies for the management of chronic pain (excluding headache) in adults (2020) · cites this paper as Guyatt 2013
The certainty of evidence was graded using the GRADE approach.
“The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach was applied.”
From The Effectiveness of Telemedicine Solutions for the Management of Type 2 Diabetes: A Systematic Review, Meta-Analysis, and Meta-Regression (2023) · cites this paper as [35]
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- Authors
- Guyatt, G. H., Thorlund, K., Oxman, A. D., Walter, S. D., Patrick, D., Furukawa, T. A., Johnston, B. C., Karanicolas, P., Akl, E. A., Vist, G., Kunz, R., Brozek, J., Kupper, L. L., Martin, S. L., Meerpohl, J. J., Alonso-Coello, P., Christensen, R., & Schunemann, H. J.
- Affiliations
- McMaster University (CA)
- Nasjonalt Kunnskapssenter for Helsetjenesten (NO)
- University of Washington (US)
- Kyoto University (JP)
- University of Toronto (CA)
- University at Buffalo, State University of New York (US)
- University Hospital of Basel (CH)
- University of North Carolina at Chapel Hill (US)
- University Medical Center Freiburg (DE)
- Frederiksberg Hospital (DK)
- Corresponding author
- Guyatt, Gordon H.
- ORCID
- Venue
- Journal of Clinical Epidemiology
- Publisher
- Elsevier BV
- Published
- 2013-02
- Volume
- 66
- Issue
- 2
- Pages
- 173-183
- ISSN
- 0895-4356 (ISSN-L)
- OpenAlex
- W2064347247
- Cited by
- 772
- References
- 9
- Citations by year
- 2026: 64 · 2025: 84 · 2024: 67 · 2023: 60 · 2022: 58 · 2021: 76 · 2020: 67 · 2019: 55 · 2018: 47 · 2017: 41 · 2016: 42 · 2015: 57 · 2014: 36 · 2013: 13 · 2012: 2
- FWCI
- 9.51
- Type
- journal article
- Language
- en
- Update notices
- erratum (2015-04-01)
- Open access
- closed
- Locations
- Journal of Clinical Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- edoc (University of Basel) (submittedVersion)
- 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
- summary of findings tables, evidence profiles, continuous outcomes, standardized mean difference, dichotomization, minimally important difference, units of measurement, heterogeneity, meta-analysis reporting
- MeSH terms
- Epidemiologic Methods, Humans, Ontario, Reproducibility of Results, Outcome Assessment, Health Care, Practice Guidelines as Topic, Total Quality Management, Evidence-Based Medicine, Guideline Adherence
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