In a GRADE assessment, review authors consider each GRADE domain (risk of bias, indirectness etc) and determine whether any methodological concerns reduce certainty in the observed effect estimate. However, identifying a potential concern in any GRADE domain does not, by itself, justify rating down the certainty of the evidence. Rating down is appropriate only when the concern introduces reasonable doubt that the true effect estimate may fall outside the target of the certainty rating.
Session 2 of the GRADE Learning Live series will cover why it is important to base GRADE ratings on the impact of any concerns and how to assess this impact.
Topics include:
- Why rate the impact not the concern?
- How to test whether a concern has an impact on the effect estimate (sensitivity and subgroup analyses)
- Worked examples
This webinar is suitable for those wanting to use GRADE to interpret and summarise findings in a systematic review. An understanding of systematic review methods and content covered in the introductory session is assumed.
Presenter Bio
Ignacio Neumann is a physician and guideline methodologist with extensive experience in evidence synthesis and the development of clinical practice guidelines. He is an active member of the GRADE Working Group, where he contributes to methodological advances in assessing certainty of evidence, defining decision thresholds, and strengthening the integration of evidence into recommendations.
He is also actively involved in the development of digital and AI-enabled tools designed to support structured evidence translation. His work focuses on preserving methodological rigor while enhancing accessibility, transparency, and the scalability of evidence-based recommendations across clinical and public health settings.
