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Assessing the quality of evidence and summarizing the findings

Cochrane Training resource: GRADE approach to evaluating evidence quality

Cochrane Interactive Learning: module 7 - interpreting the findings

 StandardRationale and elaborationResources
C74Assessing the certainty of the body of evidenceMandatory 
 Use the five GRADE considerations (risk of bias, consistency of effect, imprecision, indirectness and publication bias) to assess the certainty of the body of evidence for each outcome, and to draw conclusions about the certainty of evidence within the text of the review. GRADE is the most widely used approach for summarizing confidence in effects of interventions by outcome across studies. It is preferable to use the online GRADEpro tool, and to use it as described in the help system of the software. This should help to ensure that author teams are accessing the same information to inform their judgments. Ideally, two people working independently should assess the certainty of the body of evidence and reach a consensus view on any downgrading decisions. The five GRADE considerations should be addressed irrespective of whether the review includes a ‘Summary of findings’ table. It is helpful to draw on this information in the Discussion, in the Authors’ conclusions and to convey the certainty in the evidence in the Abstract and Plain language summary.  

See Handbook Section 14.2.1

Common issues in Summary of Findings tables.

Planning GRADE and Summary of Findings tables.

Incorporating GRADE in Cochrane Reviews.

C75Justifying assessments of the certainty of the body of evidenceMandatory 
 Justify and document all assessments of the certainty of the body of evidence (for example downgrading or upgrading if using GRADE). The adoption of a structured approach ensures transparency in formulating an interpretation of the evidence, and the result is more informative to the user.See Handbook Section 14.2.1

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