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Thornton J, Alderson P, Tan T, et al. Introducing GRADE across the NICE clinical guideline program. J Clin Epidemiol. 2012;66(2):124-31doi: 10.1016/j.jclinepi.2011.12.007.
Thornton, J., Alderson, P., Tan, T., Turner, C., Latchem, S., Shaw, E., Ruiz, F., Reken, S., Mugglestone, M. A., Hill, J., Neilson, J., Westby, M., Francis, K., Whittington, C., Siddiqui, F., Sharma, T., Kelly, V., Ayiku, L., & Chamberlain, K. (2013). Introducing GRADE across the NICE clinical guideline program. Journal of clinical epidemiology, 66(2), 124-31. https://doi.org/10.1016/j.jclinepi.2011.12.007
Thornton, Judith, et al. "Introducing GRADE across the NICE clinical guideline program." Journal of clinical epidemiology vol. 66,2 (2013): 124-31. doi: https://doi.org/10.1016/j.jclinepi.2011.12.007
Thornton J, Alderson P, Tan T, Turner C, Latchem S, Shaw E, Ruiz F, Reken S, Mugglestone MA, Hill J, Neilson J, Westby M, Francis K, Whittington C, Siddiqui F, Sharma T, Kelly V, Ayiku L, Chamberlain K. Introducing GRADE across the NICE clinical guideline program. J Clin Epidemiol. 2013 Feb;66(2):124-31. doi: 10.1016/j.jclinepi.2011.12.007. Epub 2012 Mar 08. PMID: 22406196.
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J Clin Epidemiol. 2013 Feb;66(2):124-31. doi: 10.1016/j.jclinepi.2011.12.007. Epub 2012 Mar 08.

Introducing GRADE across the NICE clinical guideline program.

Journal of clinical epidemiology

Judith Thornton, Philip Alderson, Toni Tan, Claire Turner, Sue Latchem, Elizabeth Shaw, Francis Ruiz, Stefanie Reken, Moira A Mugglestone, Jennifer Hill, Julie Neilson, Maggie Westby, Karen Francis, Craig Whittington, Faisal Siddiqui, Tarang Sharma, Victoria Kelly, Lynda Ayiku, Kathryn Chamberlain

Affiliations

  1. Centre for Clinical Practice, National Institute for Health and Clinical Excellence, City Tower, Piccadilly Plaza, Manchester M1 4BD, United Kingdom. [email protected]

PMID: 22406196 DOI: 10.1016/j.jclinepi.2011.12.007

Abstract

OBJECTIVES: Grading of Recommendations Assessment, Development and Evaluation (GRADE) is a system for rating the confidence in estimates of effect and grading guideline recommendations. It promotes evaluation of the quality of the evidence for each outcome and an assessment of balance between desirable and undesirable outcomes leading to a judgment about the strength of the recommendation. In 2007, the National Institute for Health and Clinical Excellence began introducing GRADE across its clinical guideline program to enable separation of judgments about the evidence quality from judgments about the strength of the recommendation.

STUDY DESIGN AND SETTING: We describe the process of implementing GRADE across guidelines.

RESULTS: Use of GRADE has been positively received by both technical staff and guideline development group members.

CONCLUSION: A shift in thinking about confidence in the evidence was required leading to a more structured and transparent approach to decision making. Practical problems were also encountered; these have largely been resolved, but some areas require further work, including the application of imprecision and presenting results from analyses considering more than two alternative interventions. The use of GRADE for nonrandomized and diagnostic accuracy studies needs to be refined.

Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

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