edoc

GRADE guidelines 6. Rating the quality of evidence-imprecision

Guyatt, Gordon H. and Oxman, Andrew D. and Kunz, Regina and Brozek, Jan and Alonso-Coello, Pablo and Rind, David and Devereaux, P. J. and Montori, Victor M. and Freyschuss, Bo and Vist, Gunn and Jaeschke, Roman and Williams, John W. and Murad, Mohammad Hassan and Sinclair, David and Falck-Ytter, Yngve and Meerpohl, Joerg and Whittington, Craig and Thorlund, Kristian and Andrews, Jeff and Schünemann, Holger J.. (2011) GRADE guidelines 6. Rating the quality of evidence-imprecision. Journal of clinical epidemiology, Vol. 64, H. 12. pp. 1283-1293.

Full text not available from this repository.

Official URL: http://edoc.unibas.ch/dok/A6004112

Downloads: Statistics Overview

Abstract

GRADE suggests that examination of 95% confidence intervals (CIs) provides the optimal primary approach to decisions regarding imprecision. For practice guidelines, rating down the quality of evidence (i.e., confidence in estimates of effect) is required if clinical action would differ if the upper versus the lower boundary of the CI represented the truth. An exception to this rule occurs when an effect is large, and consideration of CIs alone suggests a robust effect, but the total sample size is not large and the number of events is small. Under these circumstances, one should consider rating down for imprecision. To inform this decision, one can calculate the number of patients required for an adequately powered individual trial (termed the "optimal information size" [OIS]). For continuous variables, we suggest a similar process, initially considering the upper and lower limits of the CI, and subsequently calculating an OIS. Systematic reviews require a somewhat different approach. If the 95% CI excludes a relative risk (RR) of 1.0, and the total number of events or patients exceeds the OIS criterion, precision is adequate. If the 95% CI includes appreciable benefit or harm (we suggest an RR of under 0.75 or over 1.25 as a rough guide) rating down for imprecision may be appropriate even if OIS criteria are met.
Faculties and Departments:03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Versicherungsmedizin > Versicherungsmedizin (Kunz)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Versicherungsmedizin > Versicherungsmedizin (Kunz)
UniBasel Contributors:Kunz, Regina
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Pergamon Press
ISSN:0895-4356
Note:Publication type according to Uni Basel Research Database: Journal article
Identification Number:
Last Modified:06 Dec 2013 09:36
Deposited On:06 Dec 2013 09:36

Repository Staff Only: item control page