The GRADE system for rating clinical guidelines
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The GRADE system was used to rate the quality of the body of evidence presented in this meta-analysis.
“The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was used to rate the quality of the body of evidence presented in this meta-analysis (27).”
From Optimal Dose and Type of Physical Activity to Improve Glycemic Control in People Diagnosed With Type 2 Diabetes: A Systematic Review and Meta-analysis (2024) · cites this paper as [27]
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Cites
Early goal-directed therapy in the treatment of severe sepsis and septic shock
Rivers, E., Nguyen, B., Havstad, S., Ressler, J., Muzzin, A., Knoblich, B., Peterson, E., & Tomlanovich, M. (2001) · New England Journal of Medicine · doi:10.1056/nejmoa010307 · Cited by 10,743 · cited 1× · see citing works
“, on the basis of the protocol of a commonly cited single-centre study”
BackgroundIntensive insulin therapy in critically ill patients.
Van den Berghe, G., Wouters, P., Weekers, F., Verwaest, C., Bruyninckx, F., Schetz, M., Vlasselaers, D., Ferdinande, P., Lauwers, P., & Bouillon, R. (2001) · New England Journal of Medicine · doi:10.1056/nejmoa011300 · Cited by 9,977 · cited 1× · see citing works
“. No evidence exists for moderate glucose control in this context, whereas the value of tight control was supported by one single-centre randomized controlled trial (RCT)”
BackgroundGrading quality of evidence and strength of recommendations
(2004) · BMJ · doi:10.1136/bmj.328.7454.1490 · Cited by 8,477 · cited 5× · see citing works
“Given also that the GRADE criteria are conveyed as ‘‘explicit and clear’’ [6], there should be little need for intensive methodological consultation from the GRADE group when experts produce guidelines.”
BackgroundInfluentialDellinger, R. P., Levy, M. M., Carlet, J. M., Bion, J., Parker, M. M., Jaeschke, R., Reinhart, K., Angus, D. C., Brun‐Buisson, C., Beale, R. J., et al. (2007) · Intensive Care Medicine · doi:10.1007/s00134-007-0934-2 · Cited by 6,722 · see citing works
Intensive versus Conventional Glucose Control in Critically Ill Patients
(2009) · New England Journal of Medicine · doi:10.1056/nejmoa0810625 · Cited by 5,119 · cited 1× · see citing works
“14) [24].”
Intensive insulin therapy in the medical ICU
Van den Berghe, G., Wilmer, A., Hermans, G., Meersseman, W., Wouters, P. J., Milants, I., Van Wijngaerden, E., Bobbaers, H., & Bouillon, R. (2006) · New England Journal of Medicine · doi:10.1056/nejmoa052521 · Cited by 3,639 · cited 2× · see citing works
“, intensive insulin therapy) in most intensive care unit (ICU) patients [18–21].”
BackgroundResultSurviving Sepsis Campaign guidelines for management of severe sepsis and septic shock
Dellinger, R. P., Carlet, J. M., Masur, H., Gerlach, H., Calandra, T., Cohen, J., Gea‐Banacloche, J., Keh, D., Marshall, J. C., Parker, M. M., et al. (2004) · Intensive Care Medicine · doi:10.1007/s00134-004-2210-z · Cited by 3,298 · see citing works
What is ‘quality of evidence’ and why is it important to clinicians?
Guyatt, G. H., Oxman, A. D., Kunz, R., Vist, G. E., Falck-Ytter, Y., & Schünemann, H. J. (2008) · BMJ · doi:10.1136/bmj.39490.551019.be · Cited by 3,250 · see citing works
Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock
Dellinger, R. P., Carlet, J. M., Masur, H., Gerlach, H., Calandra, T., Cohen, J., Gea‐Banacloche, J., Keh, D., Marshall, J. C., Parker, M. M., et al. (2004) · Critical Care Medicine · doi:10.1097/01.ccm.0000117317.18092.e4 · Cited by 3,012 · cited 4× · see citing works
“In 2004 the SSC guidelines recommended that for serious sepsis, intravenous antibiotic therapy should be rapidly instituted [10]; this guideline was given a grade ‘‘E.”
BackgroundMethodInfluentialUsers' guides to the medical literature
Guyatt, G. H. (1993) · JAMA · doi:10.1001/jama.270.17.2096 · Cited by 2,970 · see citing works
Intensive insulin therapy and pentastarch resuscitation in severe sepsis
Brunkhorst, F. M., Engel, C., Bloos, F., Meier-Hellmann, A., Ragaller, M., Weiler, N., Moerer, O., Gruendling, M., Oppert, M., Grond, S., et al. (2008) · New England Journal of Medicine · doi:10.1056/nejmoa070716 · Cited by 2,921 · cited 2× · see citing works
“Yet the senior author of that report [18], Konrad Reinhart, is a coauthor of the SSC guidelines that gave a grade 1 ranking (strong recommendation) for ‘‘moderate’’ glucose control and a grade 2 endorsement (a suggestion) for ‘‘tight’’ glucose control [11].”
Background(2004) · New England Journal of Medicine · doi:10.1056/nejmoa032193 · Cited by 2,565 · cited 1× · see citing works
“The results of three randomized controlled trials examining the effect of PEEP in acute respiratory distress syndrome (ARDS) [54–56] were made available before the 2008 SSC conference [11].”
BackgroundDellinger, R. P. (2004) · Critical Care Medicine · Cited by 1,848 · see citing works
Eagle, K. A., Berger, P. B., Calkins, H. G., CHAITMAN, B. R., Ewy, G. A., Fleischmann, K. E., Fleisher, L. A., Froehlich, J. B., Gusberg, R. J., Leppo, J. A., et al. (2002) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(01)01788-0 · Cited by 1,687 · see citing works
ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery
Fleisher, L. A., Beckman, J. A., Brown, K. A., Calkins, H. G., Chaikof, E. L., Fleischmann, K. E., Freeman, W. K., Froehlich, J. B., Kasper, E. K., Kersten, J. R., et al. (2007) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2007.09.003 · Cited by 1,419 · see citing works
Meade, M. O., Cook, D. J., Guyatt, G. H., Slutsky, A. S., Arabi, Y. M., Cooper, D. J., Davies, A. R., Hand, L. E., Zhou, Q., Thabane, L., et al. (2008) · JAMA · doi:10.1001/jama.299.6.637 · Cited by 1,370 · cited 1× · see citing works
“The results of three randomized controlled trials examining the effect of PEEP in acute respiratory distress syndrome (ARDS) [54–56] were made available before the 2008 SSC conference [11].”
BackgroundRules of Evidence and Clinical Recommendations on the Use of Antithrombotic Agents
Sackett, D. L. (1989) · CHEST Journal · doi:10.1378/chest.95.2_supplement.2s · Cited by 1,369 · cited 1× · see citing works
“’’ The grading system that was in use in 2004 was adopted from Sackett’s 1989 description [3]: in both cases an ‘‘E’’ grade corresponded to a recommendation that was supported by so-called level IV or V evidence (nonrandomized, historical controls, uncontrolled studies, expert opinion)—the lowest levels possible [10].”
MethodMercat, A., Richard, J.-C. M., Vielle, B., Jaber, S., Osman, D., Diehl, J.-L., Lefrant, J.-Y., Prat, G., Richecoeur, J., Nieszkowska, A., et al. (2008) · JAMA · doi:10.1001/jama.299.6.646 · Cited by 1,344 · see citing works
Atkins, D., Eccles, M., Flottorp, S., Guyatt, G. H., Henry, D., Hill, S., Liberati, A., O'Connell, D., Oxman, A. D., Phillips, B., et al. (2004) · BMC Health Services Research · doi:10.1186/1472-6963-4-38 · Cited by 1,235 · cited 2× · see citing works
“Atkins and colleagues, from the GRADE Working Group, compared six different systems (Box 2) [9].”
BackgroundGrading Strength of Recommendations and Quality of Evidence in Clinical Guidelines
Guyatt, G., Gutterman, D., Baumann, M. H., Addrizzo-Harris, D., Hylek, E. M., Phillips, B., Raskob, G., Lewis, S. Z., & Schünemann, H. (2006) · Chest · doi:10.1378/chest.129.1.174 · Cited by 1,220 · cited 1× · see citing works
“The GRADE documents suggested that strong recommendations should require little debate and would be implemented in most circumstances [7,29].”
BackgroundA comparison of aprotinin and lysine analogues in high-risk cardiac surgery.
Fergusson, D., Hébert, P. C., Mazer, C., Fremes, S., MacAdams, C., Murkin, J., Teoh, K., Duke, P., Arellano, R., Blajchman, M., et al. (2008) · New England Journal of Medicine · doi:10.1056/nejmoa0802395 · Cited by 1,117 · cited 2× · see citing works
“But assuming that the subsequent RCTs were appropriately conducted [5,35], the original high-level recommendations were clearly misguided [4,33– 34].”
BackgroundFerraris, V. A., Ferraris, S. P., Saha, S. P., Hessel, E. A., Haan, C. K., Royston, B., Bridges, C. R., Higgins, R. S. D., Despotis, G. J., Brown, J. R., et al. (2007) · The Annals of Thoracic Surgery · doi:10.1016/j.athoracsur.2007.02.099 · Cited by 954 · cited 2× · see citing works
“High-level recommendations using other grading systems strongly advocated use of beta-blockade (class I, IIa) [33–34] and aprotinin (class 1a) [4] in specific surgical populations.”
BackgroundQuality of Care, Process, and Outcomes in Elderly Patients With Pneumonia
Meehan, T. P. (1997) · JAMA · doi:10.1001/jama.1997.03550230056037 · Cited by 916 · cited 1× · see citing works
“Three studies published between 2004 and 2008 (none of them randomized controlled trials) supported the idea that early antibiotics reduced mortality in sepsis [45–47], exactly the same conclusions reached by at least six others published before 2004 [48–53].”
ResultPreiser, J.-C., Devos, P., Ruiz-Santana, S., Mélot, C., Annane, D., Groeneveld, J., Iapichino, G., Leverve, X., Nitenberg, G., Singer, P., et al. (2009) · Intensive Care Medicine · doi:10.1007/s00134-009-1585-2 · Cited by 911 · see citing works
Users' Guides to the Medical Literature: IX. A Method for Grading Health Care Recommendations
Guyatt, G. H. (1995) · JAMA · doi:10.1001/jama.1995.03530220066035 · Cited by 846 · cited 2× · see citing works
“Systems for Grading Evidence and Issuing Guidelines Based on the Evidence Atkins and colleagues compared the following six systems [6]: N The American College of Chest Physicians Evidence-Based Guidelines (http:// www.chestnet.org/education/hsp/guidelinesProducts.php) N Australian National Health and Medical Research…”
MethodHouck, P. M., Bratzler, D. W., Nsa, W., Ma, A., & Bartlett, J. G. (2004) · Archives of Internal Medicine · doi:10.1001/archinte.164.6.637 · Cited by 793 · cited 1× · see citing works
“Three studies published between 2004 and 2008 (none of them randomized controlled trials) supported the idea that early antibiotics reduced mortality in sepsis [45–47], exactly the same conclusions reached by at least six others published before 2004 [48–53].”
ResultLodise, T. P., McKinnon, P. S., Swiderski, L., & Rybak, M. J. (2003) · Clinical Infectious Diseases · doi:10.1086/375057 · Cited by 604 · cited 1× · see citing works
“Three studies published between 2004 and 2008 (none of them randomized controlled trials) supported the idea that early antibiotics reduced mortality in sepsis [45–47], exactly the same conclusions reached by at least six others published before 2004 [48–53].”
ResultGandhi, G. Y., Nuttall, G. A., Abel, M., Mullany, C. J., Schaff, H. V., O’Brien, P. C., Johnson, M. G., Williams, A. R., Cutshall, S. M., Mundy, L. M., et al. (2007) · Annals of Internal Medicine · doi:10.7326/0003-4819-146-4-200702200-00002 · Cited by 603 · cited 2× · see citing works
“, intensive insulin therapy) in most intensive care unit (ICU) patients [18–21].”
BackgroundResultACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery
Fleisher, L. A., Beckman, J. A., Brown, K. A., Calkins, H. G., Chaikof, E. L., Fleischmann, K. E., Freeman, W. K., Froehlich, J. B., Kasper, E. K., Kersten, J. R., et al. (2007) · Circulation · doi:10.1161/circulationaha.107.185699 · Cited by 592 · see citing works
Schünemann, H. J., Jaeschke, R., Cook, D. J., Bria, W. F., El-Solh, A. A., Ernst, A., Fahy, B. F., Gould, M. K., Horan, K. L., Krishnan, J. A., et al. (2006) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200602-197st · Cited by 577 · cited 6× · see citing works
“adopted as a policy by regulatory bodies [7].”
BackgroundInfluentialKang, C., Kim, S., Kim, H. B., Park, S., Choe, Y., Oh, M., Kim, E.-C., & Choe, K. W. (2003) · Clinical Infectious Diseases · doi:10.1086/377200 · Cited by 566 · cited 1× · see citing works
“Three studies published between 2004 and 2008 (none of them randomized controlled trials) supported the idea that early antibiotics reduced mortality in sepsis [45–47], exactly the same conclusions reached by at least six others published before 2004 [48–53].”
ResultThe Periodic Health Examination
Frappier-Davignon, L. (1934) · New England Journal of Medicine · doi:10.1056/nejm193401252100413 · Cited by 488 · see citing works
Proulx, N., Frechette, D., Toye, B., Chan, J., & Kravcik, S. (2005) · QJM · doi:10.1093/qjmed/hci047 · Cited by 454 · cited 1× · see citing works
“Three studies published between 2004 and 2008 (none of them randomized controlled trials) supported the idea that early antibiotics reduced mortality in sepsis [45–47], exactly the same conclusions reached by at least six others published before 2004 [48–53].”
ResultNational estimates of severe sepsis in United States emergency departments
Wang, H. E., Shapiro, N. I., Angus, D. C., & Yealy, D. M. (2007) · Critical Care Medicine · doi:10.1097/01.ccm.0000277043.85378.c1 · Cited by 417 · cited 1× · see citing works
“First, sepsis encompasses all medical and surgical specialties, accounts for over 500,000 emergency visits per year in North America alone [12], and when accompanied by shock has a mortality of over 50% [13].”
BackgroundEagle, K. A., Berger, P. B., Calkins, H. G., CHAITMAN, B. R., Ewy, G. A., Fleischmann, K. E., Fleisher, L. A., Froehlich, J. B., Gusberg, R. J., Leppo, J. A., et al. (2002) · Circulation · doi:10.1161/circ.105.10.1257 · Cited by 412 · see citing works
Atkins, D. C., Briss, P. A., Eccles, M., Flottorp, S. A., Guyatt, G. H., Harbour, R., Hill, S. R., Jaeschke, R., Liberati, A., Magrini, N., et al. (2005) · BMC Health Services Research · doi:10.1186/1472-6963-5-25 · Cited by 331 · see citing works
Swiglo, B. A., Murad, M. H., Schünemann, H. J., Kunz, R., Vigersky, R. A., Guyatt, G. H., & Montori, V. M. (2008) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2007-1907 · Cited by 302 · see citing works
Letters, numbers, symbols and words: how to communicate grades of evidence and recommendations.
Schünemann, H. J., Best, D., Vist, G. E., & Oxman, A. D. (2003) · PubMed Central · Cited by 289 · see citing works
Improved survival of critically ill cancer patients with septic shock
Larché, J., Azoulay, É., Fieux, F., Mesnard, L., Moreau, D., Thiéry, G., Darmon, M., Gall, J. L., & Schlemmer, B. (2003) · Intensive Care Medicine · doi:10.1007/s00134-003-1957-y · Cited by 282 · cited 1× · see citing works
“Three studies published between 2004 and 2008 (none of them randomized controlled trials) supported the idea that early antibiotics reduced mortality in sepsis [45–47], exactly the same conclusions reached by at least six others published before 2004 [48–53].”
ResultThe periodic health examination. Canadian Task Force on the Periodic Health Examination.
(1979) · PubMed Central · Cited by 281 · see citing works
Clinical Recommendations Using Levels of Evidence for Antithrombotic Agents
Cook, D. J., Guyatt, G. H., Laupacis, A., Sackett, D. L., & Goldberg, R. J. (1995) · CHEST Journal · doi:10.1378/chest.108.4_supplement.227s · Cited by 275 · cited 1× · see citing works
“proposed in publications from McMaster University [1–3], with the idea of categorizing individual studies into grades of”
BackgroundNational Institute for Health and Clinical Excellence
(2008) · Nursing Standard · doi:10.7748/ns2008.08.22.50.30.p4587 · Cited by 260 · see citing works
NATIONAL GUIDELINE CLEARINGHOUSE
STOKOWSKI, L. A. (2005) · Advances in Neonatal Care · doi:10.1016/j.adnc.2005.07.009 · Cited by 237 · see citing works
Kumar, A., Haery, C., Paladugu, B. P., Kumar, A., Symeoneides, S., Taiberg, L., Osman, J., Trenholme, G. M., Opal, S. M., Goldfarb, R. D., et al. (2005) · The Journal of Infectious Diseases · doi:10.1086/498909 · Cited by 222 · see citing works
Surviving Sepsis — Practice Guidelines, Marketing Campaigns, and Eli Lilly
Eichacker, P. Q., Natanson, C., & Danner, R. L. (2006) · New England Journal of Medicine · doi:10.1056/nejmp068197 · Cited by 213 · cited 1× · see citing works
“I focus only on grading (Boxes 3 and 4), not on the controversies surrounding the SSC [15], and I do not express support for—or criticism of—any of its recommendations.”
BackgroundMiner, J. R., Heegaard, W. G., Mapes, A., & Biros, M. H. (2001) · Journal of Emergency Medicine · doi:10.1016/s0736-4679(01)00407-3 · Cited by 147 · cited 1× · see citing works
“Three studies published between 2004 and 2008 (none of them randomized controlled trials) supported the idea that early antibiotics reduced mortality in sepsis [45–47], exactly the same conclusions reached by at least six others published before 2004 [48–53].”
ResultAn emerging consensus on grading recommendations?
Guyatt, G. H. (2006) · BMJ Evidence-Based Medicine · doi:10.1136/ebm.11.1.2-a · Cited by 142 · cited 1× · see citing works
“The basis for the GRADE system is articulated in several publications [6– 7,9,16,29–31], but none contains supportive data, proof, or logical argument for the system.”
BackgroundGacouin, A., Tulzo, Y. L., Lavoué, S., Camus, C., Hoff, J., Bassen, R., Arvieux, C., Heurtin, C., & Thomas, R. (2002) · Intensive Care Medicine · doi:10.1007/s00134-002-1304-8 · Cited by 136 · cited 1× · see citing works
“Three studies published between 2004 and 2008 (none of them randomized controlled trials) supported the idea that early antibiotics reduced mortality in sepsis [45–47], exactly the same conclusions reached by at least six others published before 2004 [48–53].”
ResultAn emerging consensus on grading recommendations?
Gordon Guyatt, M., Gunn Vist, P., Yngve Falck-Ytter, M., Regina Kunz, M., Nicola Magrini, M., & Holger Schunemann, M. (2006) · ACP Journal Club · doi:10.7326/acpjc-2006-144-1-a08 · Cited by 79 · see citing works
Intensive Insulin Therapy in Postoperative Intensive Care Unit Patients
Egi, M., Bellomo, R., Stachowski, E., French, C., Hart, G. K., Stow, P. J., Li, W., & Bates, S. (2005) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200506-961oc · Cited by 64 · cited 1× · see citing works
“, intensive insulin therapy) in most intensive care unit (ICU) patients [18–21].”
BackgroundIatrogenic illness: a call for decision support tools to reduce unnecessary variation
Morris, A. H. (2004) · BMJ Quality & Safety · doi:10.1136/qshc.2002.003871 · Cited by 47 · see citing works
Transforming Clinical Practice Guidelines Into Legislative Mandates
Jacobson, P. (2008) · JAMA · doi:10.1001/jama.2007.12 · Cited by 44 · cited 1× · see citing works
“about proposals to convert guidelines into law [43–44].”
BackgroundOvalle, F. (2010) · Yearbook of Endocrinology · doi:10.1016/s0084-3741(10)79602-5 · Cited by 26 · see citing works
Clermont, G., Angus, D. C., Kalassian, K. G., Linde‐Zwirble, W. T., Ramakrishnan, N., Linden, P. K., & Pinsky, M. R. (2003) · Critical Care Medicine · doi:10.1097/01.ccm.0000094233.35059.81 · Cited by 19 · cited 1× · see citing works
“First, sepsis encompasses all medical and surgical specialties, accounts for over 500,000 emergency visits per year in North America alone [12], and when accompanied by shock has a mortality of over 50% [13].”
BackgroundClinical practice guidelines: Culture eats strategy for breakfast, lunch, and dinner*
Fein, I. A., & Corrato, R. R. (2008) · Critical Care Medicine · doi:10.1097/ccm.0b013e31816a1260 · Cited by 15 · cited 1× · see citing works
“about proposals to convert guidelines into law [43–44].”
BackgroundThe Highs and Lows of Intensive Insulin Therapy
Fowler, R., & Annane, D. (2006) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.2510006 · Cited by 14 · cited 1× · see citing works
“First, glucose control in the critically ill is a complex issue [17].”
BackgroundFlanagan, P. A. (1997) · PubMed · Cited by 12 · see citing works
Dellinger, R. P., Levy, M. M., Carlet, J. M., Bion, J., Parker, M. M., Jaeschke, R., Reinhart, K., Angus, D. C., Brun-Buisson, C., Beale, R., et al. (2008) · Critical Care Medicine · doi:10.1097/01.ccm.0000298158.12101.41 · Cited by 9 · see citing works
New plan proposed to help resolve conflicting medical advice
Wadman, M. (2008) · Nature Medicine · doi:10.1038/nm0308-226a · Cited by 3 · see citing works
(2008) · Nature Medicine · doi:10.1038/nm0308-223 · Cited by 1 · see citing works
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Clinical Practice Guidelines We Can Trust
Board on Health Care Services (2011) · National Academies Press eBooks · doi:10.17226/13058 · Cited by 3,102 · see citing works
Association of the Extent of Resection With Survival in Glioblastoma
Brown, T. J., Brennan, M., Li, M. J., Church, E. W., Brandmeir, N. J., Rakszawski, K. L., Patel, A. S., Rizk, E., Suki, D., Sawaya, R. A., et al. (2016) · JAMA Oncology · doi:10.1001/jamaoncol.2016.1373 · Cited by 1,087 · see citing works
Guidelines International Network: Toward International Standards for Clinical Practice Guidelines
Qaseem, A., Forland, F., Macbeth, F., Ollenschläger, G., Phillips, S., van der Wees, P., & for the Board of Trustees of the Guidelines International Network* (2012) · Annals of Internal Medicine · doi:10.7326/0003-4819-156-7-201204030-00009 · Cited by 902 · see citing works
“Clear identification of the quality of evidence helps, and strength of clinical recommendations increases the trustworthiness and improves the implementation of clinical guidelines (32, 43, 76).”
BackgroundGuiding Principles for the Care of Older Adults with Multimorbidity: An Approach for Clinicians
American Geriatrics Society Expert Panel on the Care of Older Adults with Multimorbidity (2012) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2012.04188.x · Cited by 667 · see citing works
Non-surgical management of knee osteoarthritis: comparison of ESCEO and OARSI 2019 guidelines
Arden, N., Perry, T. A., Bannuru, R. R., Bruyère, O., Cooper, C. C., Haugen, I. K., Hochberg, M. C., McAlindon, T. E., Mobasheri, A., & Reginster, J. (2020) · Nature Reviews Rheumatology · doi:10.1038/s41584-020-00523-9 · Cited by 582 · see citing works
Murray, M. J., DeBlock, H. F., Erstad, B. L., Gray, A. W., Jacobi, J., Jordan, C. J., McGee, W. T., McManus, C., Meade, M. O., Nix, S. A., et al. (2016) · Critical Care Medicine · doi:10.1097/ccm.0000000000002027 · Cited by 514 · see citing works
“The Task Force used the GRADE system to rate the quality of evidence and strength of the recommendation for each clinical practice question (8).”
MethodDigital health: a path to validation
Mathews, S. C., McShea, M. J., Hanley, C. L., Ravitz, A., Labrique, A. B., & Cohen, A. B. (2019) · npj Digital Medicine · doi:10.1038/s41746-019-0111-3 · Cited by 508 · see citing works
Li, X., Meng, X., Timofeeva, M. N., Tzoulaki, I., Tsilidis, K. K., Ioannidis, J. P. A., Campbell, H. J., & Τheodoratou, E. (2017) · BMJ · doi:10.1136/bmj.j2376 · Cited by 402 · see citing works
Annane, D., Pastores, S., Rochwerg, B., Arlt, W., Balk, R., Beishuizen, A., Briegel, J., Carcillo, J., Christ-Crain, M., Cooper, M., et al. (2018) · Intensive Care Medicine · doi:10.1007/s00134-017-4919-5 · Cited by 434 · see citing works
“Each recommendation was designated either “strong” or “conditional” according to the GRADE approach [7].”
BackgroundAnnane, D., Pastores, S. M., Rochwerg, B. N., Arlt, W., BALK, R. A., Beishuizen, A., Briegel, J., Carcillo, J. A., Christ‐Crain, M., Cooper, M. S., et al. (2017) · Critical Care Medicine · doi:10.1097/ccm.0000000000002737 · Cited by 343 · see citing works
American Geriatrics Society Expert Panel on the Care of Older Adults with Multimorbidity (2012) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2012.04187.x · Cited by 309 · see citing works
ESPEN endorsed recommendations: Nutritional therapy in major burns
Rousseau, A.-F., Losser, M.-R., Ichai, C., & Berger, M. M. (2013) · Clinical Nutrition · doi:10.1016/j.clnu.2013.02.012 · Cited by 388 · see citing works
The challenge of de‐labeling penicillin allergy
Stone, C. A., Trubiano, J. A., Coleman, D. T., Rukasin, C. R. F., & Phillips, E. J. (2019) · Allergy · doi:10.1111/all.13848 · Cited by 270 · see citing works
Gallardo-Gómez, D., del Pozo-Cruz, J., Noetel, M., Álvarez-Barbosa, F., Alfonso-Rosa, R. M., & del Pozo Cruz, B. (2022) · Ageing Research Reviews · doi:10.1016/j.arr.2022.101591 · Cited by 268 · see citing works
“The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) system was used to rate the quality of evidence (Kavanagh, 2009).”
Hegyi, P. J., Petersen, O. H., Holgate, S. T., Erőss, B. M., Garami, A., Szakács, Z., Dobszai, D., Balaskó, M., Kemény, L. V., Peng, S., et al. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9051532 · Cited by 243 · see citing works
“, the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) system) when rating quality of evidence and formulating the strength of recommendations (main target audience: clinical practitioners and scientists) [43,44].”
BackgroundTacconelli, E., Mazzaferri, F., de Smet, A. M. G. A., Bragantini, D., Eggimann, P., Huttner, B. D., Kuijper, E. J., Lucet, J. C., Mutters, N. T., Sanguinetti, M., et al. (2019) · Clinical Microbiology and Infection · doi:10.1016/j.cmi.2019.01.005 · Cited by 236 · see citing works
“Evidence certainty of controlled studies was classified as high, moderate, low or very low, and recommendation strength was classified as strong or conditional according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system [37].”
MethodConsensus guidelines for the diagnosis and management of invasive aspergillosis, 2021
Douglas, A. P., Smibert, O. C., Bajel, A. R., Halliday, C. L., Lavee, O., McMullan, B. J., Yong, M. K., van Hal, S. J., & Chen, S. C. ‐. (2021) · Internal Medicine Journal · doi:10.1111/imj.15591 · Cited by 185 · see citing works
Poonacha, T. K., & Go, R. S. (2010) · Journal of Clinical Oncology · doi:10.1200/jco.2010.31.6414 · Cited by 158 · see citing works
Monitoring nutrition in the ICU
Berger, M. M., Reintam-Blaser, A., Calder, P. C., Casaer, M., Hiesmayr, M. J., Mayer, K., Montejo, J. C., Pichard, C., Preiser, J.-C., van Zanten, A. R. H., et al. (2019) · Clinical Nutrition · doi:10.1016/j.clnu.2018.07.009 · Cited by 171 · see citing works
Psychological treatment of dental anxiety among adults: A systematic review
Wide Boman, U., Carlsson, V., Westin, M., & Hakeberg, M. (2013) · European Journal of Oral Sciences · doi:10.1111/eos.12032 · Cited by 142 · see citing works
ESCMID rapid guidelines for assessment and management of long COVID
Yelin, D., Moschopoulos, C. D., Margalit, I., Gkrania‐Klotsas, E., Landi, F., Stahl, J. ‐., & Yahav, D. (2022) · Clinical Microbiology and Infection · doi:10.1016/j.cmi.2022.02.018 · Cited by 145 · see citing works
“We planned to classify evidence certainty per question as high, moderate, low, or very low and recommendation strength as strong or conditional according to the GRADE system [16].”
Low-Intensity Transcranial Current Stimulation in Psychiatry
Philip, N. S., Nelson, B. G., Frӧhlich, F., Lim, K. O., Widge, A. S., & Carpenter, L. L. (2017) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2017.16090996 · Cited by 139 · see citing works
“c The 21-itemquality checklist was developed (see supplements 1 and 2) on the basis of GRADE scoring guidelines (20).”
BackgroundMethodInfluentialEuropean Recommendations on Organisation of Interventional Care in Acute Stroke (EROICAS)
Fiehler, J., Cognard, C., Gallitelli, M., Jansen, O., Kobayashi, A., Mattle, H. P., Muir, K. W., Mazighi, M., Schaller, K., & Schellinger, P. D. (2016) · International Journal of Stroke · doi:10.1177/1747493016647735 · Cited by 132 · see citing works
“Similar to the GRADE approach,(15) quality of evidence was graded into high, moderate, low, and very low.”
BackgroundMethodBarbui, C., Dua, T., van Ommeren, M., Yasamy, M. T., Fleischmann, A., Clark, N. C., Thornicroft, G., Hill, S. R., & Saxena, S. (2010) · PLoS Medicine · doi:10.1371/journal.pmed.1000322 · Cited by 119 · see citing works
“In areas characterized by the presence of many randomized trials, however, such as antidepressants for major depression where single reviews may include more than 100 trials, this posed a practical problem, in terms of feasibility (to access all primary studies), and also in terms of reproducibility and consistency [1…”
BackgroundKhan, A. R., Khan, S., Zimmerman, V. A., Baddour, L. M., & Tleyjeh, I. M. (2010) · Clinical Infectious Diseases · doi:10.1086/656735 · Cited by 116 · see citing works
New and improved tuberculosis diagnostics: evidence, policy, practice, and impact
Pai, M., Minion, J., Steingart, K. R., & Ramsay, A. (2010) · Current Opinion in Pulmonary Medicine · doi:10.1097/mcp.0b013e328338094f · Cited by 114 · see citing works
Gallardo-Gómez, D., Salazar-Martínez, E., Alfonso-Rosa, R. M., Ramos-Munell, J., del Pozo-Cruz, J., del Pozo Cruz, B., & Álvarez-Barbosa, F. (2024) · Diabetes Care · doi:10.2337/dc23-0800 · Cited by 111 · see citing works
Grading Quality of Evidence and Strength of Recommendations: A Perspective
Ansari, M., Tsertsvadze, A., & Moher, D. (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000151 · Cited by 110 · see citing works
“In a new Policy Forum published in this issue of PLoS Medicine, Kavanagh [9] questions the external consistency of the GRADE framework by comparing the Surviving Sepsis Campaign (SSC) guideline recommendations developed in 2004 and”
MethodGuidelines for best practices in monitoring established coeliac disease in adult patients
Elli, L., Leffler, D. A., Cellier, C., Lebwohl, B., Ciacci, C., Schümann, M., Lundin, K. E. A., Zammit, S. C., Sidhu, R., Roncoroni, L., et al. (2023) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/s41575-023-00872-2 · Cited by 109 · see citing works
“The levels of certainty of the evidence and strength of the recommendations were defined for every part of the statement, according to the GRADE system using GRADEpro 23 .”
Statins and Multiple Noncardiovascular Outcomes
He, Y., Li, X., Gašević, D., Brunt, E., McLachlan, F., Millenson, M. E., Timofeeva, M. N., Ioannidis, J. P. A., Campbell, H. J., & Τheodoratou, E. (2018) · Annals of Internal Medicine · doi:10.7326/m18-0808 · Cited by 96 · see citing works
Zhu, F., Zhu, X., Bi, X., Kuang, D., Liu, B., Zhou, J., Yang, Y., & Ren, Y. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1133727 · Cited by 89 · see citing works
“” The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) system was used in this study to judge the quality of evidence (27).”
MethodMethodological considerations of the GRADE method
Malmivaara, A. V. (2014) · Annals of Medicine · doi:10.3109/07853890.2014.969766 · Cited by 90 · see citing works
Devlin, J. W., Skrobik, Y. K., Rochwerg, B. N., Nunnally, M., Needham, D. M., Gélinas, C., Pandharipande, P. P., Slooter, A. J. C., Watson, P. L., Weinhouse, G. L., et al. (2018) · Critical Care Medicine · doi:10.1097/ccm.0000000000003298 · Cited by 87 · see citing works
Wright, J. D., Pawar, N., Gonzalez, J. S. R., Lewin, S. N., Burke, W. M., Simpson, L. L., Charles, A. S., D’Alton, M. E., & Herzog, T. J. (2011) · Obstetrics and Gynecology · doi:10.1097/aog.0b013e3182267f43 · Cited by 84 · see citing works
Use of Novel Strategies to Develop Guidelines for Management of Pyogenic Osteomyelitis in Adults
Spellberg, B. J., Aggrey, G., Brennan, M. B., Footer, B. W., Forrest, G. N., Hamilton, F., Minejima, E., Moore, J., Ahn, J., Angarone, M., et al. (2022) · JAMA Network Open · doi:10.1001/jamanetworkopen.2022.11321 · Cited by 83 · see citing works
“1-7 Instead, the group sought to incorporate the “humility of uncertainty”7 by only providing clear recommendations when reproducible, high-quality, hypothesis-confirming evidence is available, requiring at a minimum: (1) 1 properly conducted, adequately powered randomized controlled trial (RCT); and (2) at least 1 ot…”
BackgroundMethodNovel Therapies for Septic Shock Over the Past 4 Decades
Suffredini, A. F., & Munford, R. S. (2011) · JAMA · doi:10.1001/jama.2011.909 · Cited by 75 · see citing works
Functional foods modulating inflammation and metabolism in chronic diseases: a systematic review
Luvián‐Morales, J., Varela-Castillo, F. O., Flores-Cisneros, L. A., Cetina, L., & Castro-Eguiluz, D. (2021) · Critical Reviews in Food Science and Nutrition · doi:10.1080/10408398.2021.1875189 · Cited by 81 · see citing works
“The quality of the trials was evaluated according to the GRADE system to decide which articles would be included in this systematic review (Kavanagh 2009).”
MethodHoenigl, M., Gangneux, J., Segal, E., Alanio, A., Chakrabarti, A., Chen, S. C. ‐., Govender, N. P., Hagen, F., Климко, Н. Н., Meis, J. F. G. M., et al. (2018) · Mycoses · doi:10.1111/myc.12836 · Cited by 73 · see citing works
Should patients with NAFLD/NASH Be surveyed for HCC?
Reig, M., Gambato, M., Man, N. K., Roberts, J. P., Victor, D., Orci, L. A., & Toso, C. (2019) · Transplantation · doi:10.1097/tp.0000000000002361 · Cited by 71 · see citing works
Tonelli, M. R., Curtis, J. R., Guntupalli, K. K., Rubenfeld, G. D., Arroliga, A. C., Brochard, L. J., Douglas, I. S., Gutterman, D. D., Hall, J. R., Kavanagh, B. P., et al. (2012) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201204-0638st · Cited by 68 · see citing works
“Furthermore, attempts to incorporate these multiple factors into a single summary expression of “strength” of a recommendation is difficult, if not impossible (56).”
Going from evidence to recommendations: Can GRADE get us there?
Mercuri, M., Baigrie, B. S., & Upshur, R. E. G. (2018) · Journal of Evaluation in Clinical Practice · doi:10.1111/jep.12857 · Cited by 61 · see citing works
Expert System for Offline Clinical Guidelines and Treatment
Saba, T., Al-Zahrani, S., Rehman, A. U., & Islamic, S. (2012) · Cited by 58 · see citing works
Preeradication Vaccine Policy Options for Poliovirus Infection and Disease Control
Thompson, K. M., Pallansch, M. A., Tebbens, R. J. D., Wassilak, S. G. F., Kim, J., & Cochi, S. L. (2013) · Risk Analysis · doi:10.1111/risa.12019 · Cited by 58 · see citing works
“We evaluated various grading options,(40,41) and eventually collapsed our assessments into three grades.”
MethodSabha, M., & Hochberg, M. C. (2021) · Osteoarthritis and Cartilage Open · doi:10.1016/j.ocarto.2021.100232 · Cited by 60 · see citing works
“The GRADE methodology combines both the literature review as well as expert opinions [18].”
MethodA systematic review of neurocognitive dysfunction with overactive bladder medications
Duong, V., Iwamoto, A., Pennycuff, J. F., Kudish, B., & Iglesia, C. B. (2021) · International Urogynecology Journal · doi:10.1007/s00192-021-04909-5 · Cited by 56 · see citing works
“The aforementioned criteria were all taken into account in determining the overall quality of evidence using modified guidelines taken from the Grades for Recommendation, Assessment, Development and Evaluation (GRADE) system [31].”
MethodD'Souza, R. S., Kubrova, E., Her, Y. F., Barman, R. A., Smith, B. J., Alvarez, G. A. M., West, T., & Abd-Elsayed, A. A. (2022) · Advances in Therapy · doi:10.1007/s12325-022-02244-9 · Cited by 54 · see citing works
“Quality of Evidence The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) quality assessment criteria [17] were used to assess the level of evidence for DRG-S use for each specific neuropathic pain diagnosis.”
MethodTrace Element Supplementation Following Severe Burn Injury
Kurmis, R., Greenwood, J. E., & Aromataris, E. (2015) · Journal of Burn Care & Research · doi:10.1097/bcr.0000000000000259 · Cited by 53 · see citing works
A Critical Evaluation of Existing Diabetic Foot Screening Guidelines
Formosa, C., Gatt, A., & Chockalingam, N. (2016) · The Review of Diabetic Studies · doi:10.1900/rds.2016.13.158 · Cited by 54 · see citing works
“…for Clinical Systems Improvement (ICSI), USA 2014 ICSI, 1014 [17] Grading of Recommendations Assessment, Development and Evaluation (GRADE) system Kavanagh, 2009 [18] Foot Screening Guidelines American Diabetes Association (ADA), USA 2014, updated 2016 ADA, 2014, S47-S49 [19] Own (ADA) ADA,…”
BackgroundMethodInfluentialThe value of observational research in liver diseases
Lindor, R. A., & Lindor, K. D. (2010) · Hepatology · doi:10.1002/hep.24082 · Cited by 49 · see citing works
“Despite these shortcomings, RCTs are still touted as the preferred form of research by a number of influential bodies, such as the US Preventive Services Task Force, the Agency for Healthcare Research and Quality, and the World Health Organization.(3,4) The preference for RCT data over observational data can be at”
BackgroundSurgical Infection Society Guidelines for Antibiotic Use in Patients with Traumatic Facial Fractures
Forrester, J. D., Wolff, C. J., Choi, J., Colling, K. P., & Huston, J. M. (2020) · Surgical Infections · doi:10.1089/sur.2020.107 · Cited by 47 · see citing works
“For the qualitative synthesis, the quality and certainty of published evidence was evaluated using the GRADE defini-tions [7,8].”
BEVA primary care clinical guidelines: Analgesia
Bowen, M., Redpath, A., Dugdale, A., Burford, J. H., Lloyd, D., Watson, T., & Hallowell, G. D. (2019) · Equine Veterinary Journal · doi:10.1111/evj.13198 · Cited by 46 · see citing works
Cao, S.-J., Chen, D., Yang, L., & Zhu, T. (2019) · BMC Anesthesiology · doi:10.1186/s12871-019-0735-5 · Cited by 45 · see citing works
“We used the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) [18] approach to rate the quality of the evidence for postoperative delirium, length of stay, readmission to hospital and admission to nursing home within 1 year.”
MethodSkrobik, Y. K., & Chanques, G. (2013) · Annals of Intensive Care · doi:10.1186/2110-5820-3-9 · Cited by 43 · see citing works
“experts [4].”
Venous leg ulcer clinical practice guidelines: what is AGREEd?
Tan, M. K. H., Luo, R., Onida, S., Maccatrozzo, S., & Davies, A. H. (2019) · European Journal of Vascular and Endovascular Surgery · doi:10.1016/j.ejvs.2018.08.043 · Cited by 43 · see citing works
Kupeli, N., Chatzitheodorou, G., Troop, N., McInnerney, D., Stone, P. C., & Candy, B. (2019) · BMC Palliative Care · doi:10.1186/s12904-019-0449-y · Cited by 45 · see citing works
Meloni, M., Giurato, L., Monge, L., Miranda, C., Scatena, A., Ragghianti, B., Silverii, G. A., Vermigli, C., CASSAI, A. D., Volpe, A., et al. (2024) · Acta Diabetologica · doi:10.1007/s00592-024-02246-9 · Cited by 41 · see citing works
“…(Associazione Medici Diabetologi, AMD), are being developed for inclusion in the Italian National Guideline System (INGS), designed as a standard reference for clinical practice in Italy using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach [12, 13].”
Robot-assisted laparoscopic pyeloplasty in children: a systematic review
Masieri, L., Sforza, S., Grosso, A. A., Valastro, F., Tellini, R., Cini, C., Landi, L., Taverna, M., Elia, A., Mantovani, A., et al. (2020) · Minerva Urologica e Nefrologica · doi:10.23736/s0393-2249.20.03854-0 · Cited by 41 · see citing works
Hartling, L., Fernandes, R. M., Seida, J. C., Vandermeer, B., & Dryden, D. M. (2012) · PLoS ONE · doi:10.1371/journal.pone.0034697 · Cited by 38 · see citing works
“Despite numerous publications about the GRADE tool (including some criticisms [16]), there have been few empirical and systematic evaluations of applying the tool in practice [17].”
MethodNarrative evidence and evidence‐based medicine
Misak, C. (2010) · Journal of Evaluation in Clinical Practice · doi:10.1111/j.1365-2753.2010.01407.x · Cited by 37 · see citing works
“The worries have piled on top of one another: EBM shifts the focus of clinical practice away from reflection on individual patients and towards populations with unhappy results for patients who are outliers [6,7]; medicine is full of grey areas where the risk benefit analysis of competing clinical options is incomplet…”
BackgroundPhysical functioning following spinal cord stimulation: a systematic review and meta-analysis
ElSaban, M., Kleppel, D. J., Kubrova, E., Alvarez, G. A. M., Hussain, N., & D'Souza, R. S. (2023) · Regional Anesthesia & Pain Medicine · doi:10.1136/rapm-2022-104295 · Cited by 36 · see citing works
Shugg, T., Pasternak, A. L., London, B., & Luzum, J. A. (2020) · npj Genomic Medicine · doi:10.1038/s41525-020-00156-7 · Cited by 35 · see citing works
Development and implementation of clinical guidelines: An artificial intelligence perspective
de Oliveira, T. C. R., Nováis, P., & Neves, J. (2013) · Artificial Intelligence Review · doi:10.1007/s10462-013-9402-2 · Cited by 34 · see citing works
Bergamot Oil: Botany, Production, Pharmacology
Valussi, M., Donelli, D., Firenzuoli, F., & Antonelli, M. (2021) · Encyclopedia · doi:10.3390/encyclopedia1010016 · Cited by 34 · see citing works
“Psoriasis Application on psoriatic plaques 30 min before UVB treatment (topical) C * Level of Evidence evaluated in accordance with the 4-tier GRADE system [78].”
MethodExercise training for improving outcomes post-burns: a systematic review and meta-analysis
Flores, O., Tyack, Z. F., Stockton, K. A., Ware, R. S., & Paratz, J. D. (2018) · Clinical Rehabilitation · doi:10.1177/0269215517751586 · Cited by 33 · see citing works
Restorative treatments of dystrophin expression in Duchenne muscular dystrophy: A systematic review
Pascual‐Morena, C., Cavero‐Redondo, I., Álvarez‐Bueno, C., Mesas, A. E., Pozuelo‐Carrascosa, D. P., & Martínez‐Vizcaíno, V. (2020) · Annals of Clinical and Translational Neurology · doi:10.1002/acn3.51149 · Cited by 33 · see citing works
“The strength of the evidence for main outcomes was assessed using the Grades of Recommendation, Assessment, Development and Evaluation tool (GRADE).(20) This tool considers three aspects: study design (i.”
MethodEuropean recommendations on organisation of interventional care in acute stroke (EROICAS)
Fiehler, J., Cognard, C., Gallitelli, M., Jansen, O., Kobayashi, A., Mattle, H. P., Muir, K. W., Mazighi, M., Schaller, K., & Schellinger, P. D. (2016) · European Stroke Journal · doi:10.1177/2396987316659033 · Cited by 33 · see citing works
Zhang, X., Liu, X., & Kang, D. (2015) · Scientific Reports · doi:10.1038/srep16582 · Cited by 32 · see citing works
Colling, K. P., Bessoff, K. E., Forrester, J. D., Kendrick, D. E., Mercier, P. J., & Huston, J. M. (2022) · Surgical Infections · doi:10.1089/sur.2021.207 · Cited by 31 · see citing works
Mumford, J., & Birchwood, J. (2020) · Pastoral Care in Education · doi:10.1080/02643944.2020.1855670 · Cited by 32 · see citing works
“Other approaches to the appraisal of qualitative evidence have been criticised for a lack of validity (Kavanagh, 2009).”
BackgroundD'Souza, R. S., Langford, B. J., Olsen, D. A., & Johnson, R. L. (2021) · Local and Regional Anesthesia · doi:10.2147/lra.s303827 · Cited by 30 · see citing works
Pinto, C. A., Iyer, V., Albitar, H. A. H., Anderson, A. L., Cajigas, H. R., Simonetto, D. A., Krowka, M. J., DuBrock, H. M., & de Moraes, A. G. (2021) · Respiratory Medicine and Research · doi:10.1016/j.resmer.2021.100852 · Cited by 30 · see citing works
Team learning and innovation in nursing, a review of the literature
Timmermans, O., van Linge, R. H., Petegem, P. V., Rompaey, B. V., & Denekens, J. (2011) · Nurse Education Today · doi:10.1016/j.nedt.2011.07.006 · Cited by 31 · see citing works
“The level of evidence in the included studies was defined through the grading system of the National Institute for Clinical Excellence (Kavanagh, 2009).”
BackgroundMethodHow can we improve the interpretation of systematic reviews?
Tricco, A. C., Straus, S. E., & Moher, D. (2011) · BMC Medicine · doi:10.1186/1741-7015-9-31 · Cited by 29 · see citing works
“Limitations of GRADE include that it requires training, provides limited guidance for examining non-intervention or non-diagnostic studies, and requires ‘scientific value judgments’ to be made about a body of evidence, which is often difficult for nonexperimental research (for example, observational studies, qualitati…”
BackgroundGuidelines for the prevention of travel-associated illness in older adults
Lee, T. K., Hutter, J. N., Masel, J., Joya, C., & Whitman, T. J. (2017) · Tropical Diseases Travel Medicine and Vaccines · doi:10.1186/s40794-017-0054-0 · Cited by 29 · see citing works
“We used the GRADE system to grade both the strength of the recommendations and the quality of the evidence [13].”
MethodDevelopment, Reporting, and Evaluation of Clinical Practice Guidelines
Benzon, H. T., Joshi, G. P., Gan, T. J., & Vetter, T. R. (2019) · Anesthesia & Analgesia · doi:10.1213/ane.0000000000004441 · Cited by 29 · see citing works
The American Society of Anesthesiologists Practice Parameter Methodology
Apfelbaum, J. L., & Connis, R. T. (2019) · Anesthesiology · doi:10.1097/aln.0000000000002551 · Cited by 28 · see citing works
Schmitter, M., Spijker, J., Smit, F., Tendolkar, I., Derksen, A.-M., Oostelbos, P., Wijnen, B. F. M., van Doesum, T., Smits, J. A. J., & Vrijsen, J. N. (2020) · BMC Psychiatry · doi:10.1186/s12888-020-02989-z · Cited by 27 · see citing works
Leclerc, T., Sjöberg, F., Jennes, S., Martínez-Méndez, J. R., van der Vlies, C. H., Battistutta, A., Basanta, J. A. L., Moiemen, N. S., & Almeland, S. K. (2022) · Burns · doi:10.1016/j.burns.2022.12.011 · Cited by 26 · see citing works
A treatment algorithm for the management of intraoral burns: A narrative review
Kang, S., Kufta, K., Sollecito, T. P., & Panchal, N. H. (2017) · Burns · doi:10.1016/j.burns.2017.09.006 · Cited by 26 · see citing works
The Use of Photoplethysmography in the Assessment of Mental Health: Scoping Review
Lyzwinski, L. N., Elgendi, M., & Menon, C. (2023) · JMIR Mental Health · doi:10.2196/40163 · Cited by 27 · see citing works
“This review followed the PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) guidelines [30].”
MethodFernández‐Jiménez, R., Martín‐Masot, R., Cornejo-Pareja, I. M., Vegas-Aguilar, I. M., Herrador‐López, M., Tinahones, F. J., Navas‐López, V. M., Bellido, D., & García‐Almeida, J. M. (2023) · Reviews in Endocrine and Metabolic Disorders · doi:10.1007/s11154-023-09817-1 · Cited by 25 · see citing works
“It has been approved to reduce the risk of bias, inconsistency of results between studies, indirect evidence, imprecision and publication bias [16, 51].”
BackgroundHydronephrosis Associated With Pelvic Organ Prolapse: A Systematic Review
Siddique, M., Ingraham, C. F., Kudish, B., Iglesia, C. B., & Polland, A. R. (2019) · Urogynecology · doi:10.1097/spv.0000000000000683 · Cited by 24 · see citing works
“Copyright © 2020 Wolters Kluwer Health | Lippincott Williams & W and Evaluation) Working Group guidelines.(13) This approach grades studies based on design and limitations of the study design, evaluates heterogeneity of results and generalizability, and assesses imprecision, which may be affected by sample size.”
BackgroundŁątka, D., Miekisiak, G. J., Jarmużek, P., Lachowski, M., & Kaczmarczyk, J. (2015) · Neurologia i Neurochirurgia Polska · doi:10.1016/j.pjnns.2015.12.001 · Cited by 22 · see citing works
“Ten RCTs on safety and effectiveness of techniques and materials limiting the development of epidural adhesions were identified and analyzed [75–83].”
BackgroundInfluentialD'Souza, R. S., Johnson, R. L., Bettini, L. M., Schulte, P. J., & Burkle, C. M. (2019) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2019.02.026 · Cited by 22 · see citing works
Modifying the GRADE framework could benefit public health
Dürrheim, D. N., & Reingold, A. L. (2010) · Journal of Epidemiology & Community Health · doi:10.1136/jech.2009.103226 · Cited by 22 · see citing works
“The merits and limitations of the GRADE framework for systematically evaluating the quality of evidence for guiding clinical practice guidelines have recently been eloquently debated.(2) 3 We will not dwell on the methodological allegations that GRADE suffers from external and internal inconsistency, potential for bia…”
BackgroundCuyper, K. D., Vanlinthout, E., Vanhoof, J. M. M., van Achterberg, T., Opgenhaffen, T., Nijs, S. L. P., Peeters, T., Put, J., Maes, B., & Audenhove, C. V. (2022) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/jpm.12890 · Cited by 23 · see citing works
Mercuri, M., & Gafni, A. (2018) · Journal of Evaluation in Clinical Practice · doi:10.1111/jep.12998 · Cited by 21 · see citing works
the Board of Trustees of the Guidelines International Network (G-I-N), van der Wees, P. J., Qaseem, A., Kaila, M., Ollenschlaeger, G., & Rosenfeld, R. M. (2012) · Systematic Reviews · doi:10.1186/2046-4053-1-3 · Cited by 20 · see citing works
“Use of an explicit and transparent strategy to evaluate evidence helps users to interpret the relative strength of the evidence [28,29].”
BackgroundBalossier, A., Sahgal, A., Kotecha, R. R., Fariselli, L., Gorgulho, A. A., Levivier, M., Ma, L., Paddick, I., Pollock, B. E., Sheehan, J. P., et al. (2023) · Neuro-Oncology · doi:10.1093/neuonc/noad253 · Cited by 20 · see citing works
Laparoscopic hysterectomy for benign indications: clinical practice guideline
Sandberg, E. M., Hehenkamp, W. J. K., Geomini, P. M. A. J., Janssen, P. F., Jansen, F. W., & Twijnstra, A. R. H. (2017) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-017-4467-9 · Cited by 20 · see citing works
“This point has been raised previously by other authors [32] and the GRADE working group [33] has stated that on occasion even low available evidence can lead to strong recommendations.”
Resultde Rijk, F. E. M., Kempeneers, M. A., Bruno, M. J., Besselink, M. G., van Goor, H., Boermeester, M. A., van Geenen, E. J., van Hooft, J. E., van Santvoort, H. C., Verdonk, R. C., et al. (2020) · United European Gastroenterology Journal · doi:10.1177/2050640620937610 · Cited by 20 · see citing works
“This resulted in a list of 39 ‘quality indicators’ (QIs), graded as strong recommendations and as high-quality evidence according to the Grading of Recommendations Assessment, Development and Evaluation system.(20) Not all QIs were applicable to every patient.”
MethodSiristatidis, C. S., Papapanou, M., Karageorgiou, V., Martins, W. P., Bellos, I., Teixeira, D. M., & Vlahos, N. (2022) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.26019 · Cited by 18 · see citing works
Current Recommendations for Perioperative Brain Health: A Scoping Review
Wooding, D. J., Field, T. S., Schwarz, S. K. W., MacDonell, S.-Y., Farmer, J. B., Rajan, S., & Flexman, A. M. (2022) · Journal of Neurosurgical Anesthesiology · doi:10.1097/ana.0000000000000861 · Cited by 19 · see citing works
Genova, P., Brunetti, F., Béquignon, É., Landi, F., Lizzi, V., Esposito, F., Charpy, C., Caldéraro, J., Azoulay, D., & de’Angelis, N. (2016) · World Journal of Surgical Oncology · doi:10.1186/s12957-016-0941-2 · Cited by 19 · see citing works
Phase angle and COVID-19: A systematic review with meta-analysis
Cornejo-Pareja, I. M., Vegas-Aguilar, I. M., Fernández‐Jiménez, R., García, C. G., Bellido, D., Tinahones, F. J., & García‐Almeida, J. M. (2023) · Reviews in Endocrine and Metabolic Disorders · doi:10.1007/s11154-023-09793-6 · Cited by 19 · see citing works
“Many organizations have endorsed GRADE method to decrease the risk of bias, inconsistency of results across studies, indirectness of evidence, imprecision and publication bias [30].”
MethodClinical trials for cognition in Parkinson's disease: Where are we and how can we do better?
Bayram, E., Batzu, L., Tilley, B. S., Gandhi, R., Jagota, P., Biundo, R., Garon, M., Prasertpan, T., Lazcano‐Ocampo, C., Chaudhuri, К. R., et al. (2023) · Parkinsonism & Related Disorders · doi:10.1016/j.parkreldis.2023.105385 · Cited by 18 · see citing works
“Phase 2 and 3 trials with positive results were then assessed using the Grades of Recommendation Assessment, Development and Evaluation (GRADE) approach [22].”
A Critical Review of Grading Systems: Implications for Public Health Policy
Irving, M., Eramudugolla, R., Cherbuin, N., & Anstey, K. J. (2017) · Evaluation & the Health Professions · doi:10.1177/0163278716645161 · Cited by 20 · see citing works
“It has been argued that grading systems are not necessarily inherently logical (Kavanagh, 2009).”
BackgroundThe Use of Bayesian Networks to Assess the Quality of Evidence from Research Synthesis: 1.
Stewart, G. B., Higgins, J. P. T., Schünemann, H. J., & Meader, N. (2015) · PLoS ONE · doi:10.1371/journal.pone.0114497 · Cited by 17 · see citing works
“GRADE is not without detractors [18].”
All That Glitters Is Not a Golden Recommendation
Prielipp, R. C., & Coursin, D. B. (2015) · Anesthesia & Analgesia · doi:10.1213/ane.0000000000000499 · Cited by 17 · see citing works
Gastine, S., Rashed, A. N., Hsia, Y., Jackson, C., Barker, C. I. S., Mathur, S., Tomlin, S., Lutsar, I., Bielicki, J. A., Standing, J. F., et al. (2019) · Expert Review of Clinical Pharmacology · doi:10.1080/17512433.2019.1695600 · Cited by 17 · see citing works
“Acknowledging GRADE philosophy [31], that evidence in the medical literature should be rated by finding categories of reliability for individual studies, we developed and employed an explicit, potentially reproducible methodology (the GAPPS system) for the assessment of PKPD studies.”
Method
- Authors
- Kavanagh, B. P.
- Affiliations
- University of Toronto (CA)
- Corresponding author
- Kavanagh, Brian P.
- Venue
- PLoS Medicine
- Publisher
- Public Library of Science (PLoS)
- Published
- 2009-09-15
- Volume
- 6
- Issue
- 9
- Pages
- e1000094
- ISSN
- 1549-1277 (ISSN-L)
- 1549-1676
- PMC
- PMC2735782
- OpenAlex
- W1991363364
- Cited by
- 246
- References
- 61
- Citations by year
- 2026: 17 · 2025: 18 · 2024: 19 · 2023: 17 · 2022: 18 · 2021: 20 · 2020: 16 · 2019: 19 · 2018: 21 · 2017: 14 · 2016: 10 · 2015: 7 · 2014: 7 · 2013: 15 · 2012: 8
- FWCI
- 9.41
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- American Thoracic Society
- World Health Organization
- University of Pennsylvania
- Society of Thoracic Surgeons
- European Respiratory Society
- Agency for Healthcare Research and Quality
- Socialstyrelsen
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Social Sciences › Sociology and Political Science › Delphi Technique in Research
- Keywords
- GRADE system, guideline quality assessment, evidence-based medicine, health policy
- MeSH terms
- Humans, Respiration, Artificial, Respiratory Distress Syndrome, Practice Guidelines as Topic, Sepsis, Evidence-Based Medicine
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