ERA

Download the full-sized PDF of From the trenches: a cross-sectional study applying the GRADE tool in systematic reviews of healthcare interventions.Download the full-sized PDF

Analytics

Share

Permanent link (DOI): https://doi.org/10.7939/R3XG9FB7Q

Download

Export to: EndNote  |  Zotero  |  Mendeley

Communities

This file is in the following communities:

Pediatrics, Department of

Collections

This file is in the following collections:

Alberta Research Centre for Health Evidence (ARCHE)

From the trenches: a cross-sectional study applying the GRADE tool in systematic reviews of healthcare interventions. Open Access

Descriptions

Author or creator
Hartling, L.
Fernandes, R. M.
Seida, J.
Vandermeer, B.
Dryden, D. M.
Additional contributors
Subject/Keyword
bronchiolitis
systematic reviews
meta-analysis
Type of item
Journal Article (Published)
Language
English
Place
Time
Description
Background GRADE was developed to address shortcomings of tools to rate the quality of a body of evidence. While much has been published about GRADE, there are few empirical and systematic evaluations. Objective To assess GRADE for systematic reviews (SRs) in terms of inter-rater agreement and identify areas of uncertainty. Design Cross-sectional, descriptive study. Methods We applied GRADE to three SRs (n = 48, 66, and 75 studies, respectively) with 29 comparisons and 12 outcomes overall. Two reviewers graded evidence independently for outcomes deemed clinically important a priori. Inter-rater reliability was assessed using kappas for four main domains (risk of bias, consistency, directness, and precision) and overall quality of evidence. Results For the first review, reliability was: κ = 0.41 for risk of bias; 0.84 consistency; 0.18 precision; and 0.44 overall quality. Kappa could not be calculated for directness as one rater assessed all items as direct; assessors agreed in 41% of cases. For the second review reliability was: 0.37 consistency and 0.19 precision. Kappa could not be assessed for other items; assessors agreed in 33% of cases for risk of bias; 100% directness; and 58% overall quality. For the third review, reliability was: 0.06 risk of bias; 0.79 consistency; 0.21 precision; and 0.18 overall quality. Assessors agreed in 100% of cases for directness. Precision created the most uncertainty due to difficulties in identifying “optimal” information size and “clinical decision threshold”, as well as making assessments when there was no meta-analysis. The risk of bias domain created uncertainty, particularly for nonrandomized studies. Conclusions As researchers with varied levels of training and experience use GRADE, there is risk for variability in interpretation and application. This study shows variable agreement across the GRADE domains, reflecting areas where further guidance is required.
Date created
2012
DOI
doi:10.7939/R3XG9FB7Q
License information
Creative Commons Attribution-Non-Commercial 3.0 Unported
Rights

Citation for previous publication
Hartling, L., Fernandes, R. M., Seida, J., Vandermeer, B., & Dryden, D. M. (2012). From the trenches: a cross-sectional study applying the GRADE tool in systematic reviews of healthcare interventions. PLoS One, 7(4), e34697. doi: 10.1371/journal.pone.0034697.
Source
Link to related item

File Details

Date Uploaded
Date Modified
2014-07-29T21:14:21.555+00:00
Audit Status
Audits have not yet been run on this file.
Characterization
File format: pdf (Portable Document Format)
Mime type: application/pdf
File size: 249770
Last modified: 2015:10:12 18:44:55-06:00
Filename: PLOS_7_4_e34697.pdf
Original checksum: 18cbee33625f7e490fa3151162cd397b
Well formed: false
Valid: false
Status message: Unexpected error in findFonts java.lang.ClassCastException: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject cannot be cast to edu.harvard.hul.ois.jhove.module.pdf.PdfDictionary offset=3067
Page count: 7
Activity of users you follow
User Activity Date