Links, summary points and a comment from me below.
Core GRADE 6: presenting the evidence in summary of findings tables
https://www.bmj.com/content/389/bmj-2024-083866
This sixth article in a seven part series presents the Core GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to summary of findings tables. Gordon Guyatt et al.
Summary points:
- Summary of findings tables present the key results of a systematic review in a transparent, structured tabular format, including benefits and harms for outcomes that are important to patients
- The tables present both relative and absolute effects, the certainty of evidence for each outcome, and the reasons for rating up or down
- When subgroups show credible effect modification, summary of findings tables may include separate rows for different subgroups
- When presenting results of binary outcomes, absolute effects are typically derived by applying relative effect estimates to baseline risks from studies representative of the target population
- When studies use different instruments to measure continuous outcomes, Core GRADE (Grading of Recommendations Assessment, Development and Evaluation) users can transform data for presentation to the units of a single preferred instrument
- Summary of findings tables should include plain language summaries, making it easier for patients, clinicians, and other interest groups to interpret the evidence
Core GRADE 7: principles for moving from evidence to recommendations and decisions
https://www.bmj.com/content/389/bmj-2024-083867
This seventh article in a seven part series presents the Core GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach for moving from evidence to recommendations or policy decisions. Gordon Guyatt et al.
Summary points
- Using Core GRADE (Grading of Recommendations Assessment, Development and Evaluation), high or moderate certainty evidence typically supports strong recommendations, whereas low or very low certainty evidence leads to conditional recommendations
- Strong recommendations are made when the desirable consequences clearly outweigh the undesirable; otherwise, recommendations are conditional
- Recommendations should reflect what matters most to patients, and should consider variability in values and preferences
- Primary considerations (benefits and harms, certainty of evidence, values and preferences) guide all recommendations; secondary factors (costs, feasibility, acceptability, and equity) become relevant from a population perspective
- Determining the smallest important benefit in each important outcome ensures recommendations focus on what is important to patients
- Explicit wording, well structured presentation formats, optimised presentation, and decision aids help clinicians and patients in shared decision making.
COMMENT (NPW): This series of seven papers from Gordon Guyatt is important as it represents a major step forward in one crucial element of the global evidence ecosystem, namely 'Synthesising evidence' and specifically systematic reviews.
https://www.hifa.org/about-hifa/hifa-vision-mission-strategy
Best wishes, Neil
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org