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, 336 (7651), 995-8

What Is "Quality of Evidence" and Why Is It Important to Clinicians?

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What Is "Quality of Evidence" and Why Is It Important to Clinicians?

Gordon H Guyatt et al. BMJ.


Guideline developers use a bewildering variety of systems to rate the quality of the evidence underlying their recommendations. Some are facile, some confused, and others sophisticated but complex

Conflict of interest statement

Competing interests: All authors are involved in the dissemination of GRADE, and GRADE’s success has a positive influence on their academic career. Authors listed in the byline have received travel reimbursement and honorariums for presentations that included a review of GRADE’s approach to rating quality of evidence and grading recommendations. GHG acts as a consultant to UpToDate; his work includes helping UpToDate in their use of GRADE. HJS is documents editor and methodologist for the American Thoracic Society; one of his roles in these positions is helping implement the use of GRADE. He is supported by “The human factor, mobility and Marie Curie actions scientist reintegration European Commission grant: IGR 42192—GRADE.”


Fig 1 Hierarchy of outcomes according to importance to patients to assess effect of phosphate lowering drugs in patients with renal failure and hyperphosphataemia
Fig 2 Downgrading for imprecision: thresholds are key (threshold number needed to treat (NNT) of 200 does not require downgrading whereas the same result with a threshold of 100 requires downgrading)
Fig 3 Effect on delayed gastric emptying of pylorus preserving pancreaticoduodenectomy compared with standard Whipple procedure for pancreatic adenocarcinoma

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