GRADE pearls and pitfalls-Part 1: Systematic reviews and meta-analyses

Zainab Al Duhailib; Anders Granholm; Waleed Alhazzani; Simon Oczkowski; Emilie Belley-Cote; Morten Hylander Møller

doi:10.1111/aas.14386

GRADE pearls and pitfalls-Part 1: Systematic reviews and meta-analyses

Acta Anaesthesiol Scand. 2024 May;68(5):584-592. doi: 10.1111/aas.14386. Epub 2024 Feb 13.

Authors

Zainab Al Duhailib^{1

2

3}, Anders Granholm^{2

4}, Waleed Alhazzani^{2

5

6

7}, Simon Oczkowski^{2

6

7}, Emilie Belley-Cote^{2

6

7

8}, Morten Hylander Møller^{2

4

9}

Affiliations

¹ Department of Critical Care Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia.
² Guidelines in Intensive Care Medicine, Development and Evaluation (GUIDE) Group, Hamilton, Ontario, Canada.
³ Department of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
⁴ Department of Intensive Care, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.
⁵ Department of Critical Care, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
⁶ Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
⁷ Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
⁸ Public Health Research Institute, Hamilton, Ontario, Canada.
⁹ Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.

PMID: 38351600
DOI: 10.1111/aas.14386

Abstract

Background: The Grading of Recommendation, Assessment, Development and Evaluation (GRADE) approach is used to assess the certainty of evidence in systematic reviews and meta-analyses.

Methods: We describe how the GRADE approach is used in systematic reviews and meta-analyses, including key points and examples. This overview is aimed at clinicians and researchers who are, or plan to be, involved in the development or assessment of systematic reviews with meta-analyses using GRADE.

Results: We outline how the certainty of evidence is assessed, how the evidence is summarized using GRADE evidence profiles or summary of findings tables, how the results are communicated, and we discuss challenges, advantages, and disadvantages with using GRADE.

Conclusions: This overview aims to provide an overview of how GRADE is used in systematic reviews and meta-analyses, and may be used by systematic review developers, methodologists, and evidence end-users.

Keywords: GRADE; meta‐analyses; systematic reviews.

Publication types

Review

MeSH terms

GRADE Approach*
Humans
Systematic Reviews as Topic