GRADE approach to evaluating the quality of evidence: a pathway
Assessing the quality of the body of evidence is a mandatory item in the Methodological standards for the conduct of new Cochrane Intervention Reviews (MECIR). GRADE is the Cochrane’s recommended approach for grading the quality of evidence and the strength of recommendations. It was proposed and developed by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Working Group.
This set of online learning resources will help you understand the GRADE approach and use it in the preparation of your Cochrane Review. The set consists of video slidecasts, a guidance document on incorporating GRADE in Cochrane Reviews, and links to additional resources, including the GRADE Handbook. Each resource is designed to be a standalone learning unit although they are presented here as a progressive learning pathway. You may choose to access the resources in any order you wish, although those new to GRADE approach may find it most productive to work through the resources in the order presented.
An introductory series of slidecasts developed by the McMaster University is a good place to start with. The series has been designed to help authors learn how to use the GRADE approach to grade the evidence in systematic reviews and create a ‘Summary of findings’ (SoF) table.
GRADEpro is the software you can use to grade the evidence and create SoF tables in your systematic review. Help files available in GRADEpro upon installation are a valuable learning resource, though for technical reasons not directly included in this pathway. A set of webinar recordings are available to guide you through the process of creating a ‘Summary of findings’ table in the new online version of the software (GRADEpro GDT).
A document developed by the Cochrane Editorial Unit provides a valuable guidance on how to bring GRADE methods and ratings into the text of your Cochrane Review.
Links to additional resources are provided at the website of Cochrane Informatics and Knowledge Management Department.
The final and the most comprehensive resource in this pathway is the GRADE Handbook, which deals in detail not only with the use of GRADE approach in systematic reviews, but also with its application in the guideline development process.
To select a resource and begin working through the pathway, click a link below.
- Introduction to GRADE approach and Summary of Findings tablesSlidecast
- Choosing comparisons and outcomes for the SoF tableSlidecast
- Applying the Risk of Bias assessments to GRADESlidecast
- How to GRADE the evidence: InconsistencySlidecast
- How to GRADE the evidence: IndirectnessSlidecast
- How to GRADE the evidence: ImprecisionSlidecast
- How to GRADE the evidence: Publication biasSlidecast
- Other factors – upgrading the quality of evidenceSlidecast
- Using GRADE and the GRADEpro GDT online software in your Cochrane Review [webinar]Slidecast
- Incorporating GRADE in Cochrane ReviewsDownloadable files
- GRADEpro – information, resources, and support
- GRADE Handbook
You may also be interested in:
- Introduction to systematic reviews: a pathway
- Diagnostic test accuracy (DTA) reviews: a pathway
- Assessing and presenting the quality of evidence in ‘Summary of findings’ table
- GDT tutorial: Creating a GRADE evidence table
- Using GRADE and the GRADEpro GDT online software in your Cochrane Review [webinar]