title: The use of GRADE approach in systematic reviews of animal studies.
abstract: OBJECTIVE
  The application of Grading of Recommendations Assessment, Development and Evaluation (GRADE) in systematic review (SR) of animal studies can promote the translation from bench to bedside. We aim to explore the use of GRADE in SRs of animal studies.
  
  
  METHODS
  We used a theoretical analysis method to explore the use of GRADE in SR of animal studies and applied in an SR of animal studies. Meanwhile, we presented and discussed our results in two international conferences.
  
  
  RESULTS
  Five downgrade factors were considered as follows in SRs of animal studies: (1) Risk of bias: the SYRCLE tool can be used for assessing the risk of bias of animal studies. (2) Indirectness: we can assess indirectness in SRs of animal studies from the PICO. (3) Inconsistency: similarity of point estimates, extent of overlap of confidence intervals (CIs), and statistical heterogeneity are also suitable to evaluate inconsistency of evidence from animal studies. (4) Imprecision: optimal information size and 95% CIs are also suitable for SRs of animal studies, like those of clinical trials. (5) Publication bias: we need to consider publication bias comprehensively through the qualitative and quantitative methods.
  
  
  CONCLUSIONS
  The methods about the use of GRADE in SR of animal studies are explicit. However, the principle about GRADE in developing the policy based on the evidence from animal studies when there is an emergency of public health.
authors.affiliation: Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.|Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China.|Chinese GRADE Center, Lanzhou University, Lanzhou, China.
authors.forename: Dang
authors.initials: D
authors.lastname: Wei
authors.affiliation: Department of Global Health, School of Public Health, Peking University, Beijing, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Tang
authors.affiliation: Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.|Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China.|Chinese GRADE Center, Lanzhou University, Lanzhou, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Institute of Social and Preventive Medicine, University of Bern, Switzerland.
authors.forename: Janne
authors.initials: J
authors.lastname: Estill
authors.affiliation: Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.|Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China.|Chinese GRADE Center, Lanzhou University, Lanzhou, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Yao
authors.affiliation: Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.|Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China.|Chinese GRADE Center, Lanzhou University, Lanzhou, China.
authors.forename: Xiaoqin
authors.initials: X
authors.lastname: Wang
authors.affiliation: Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.|Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China.|Chinese GRADE Center, Lanzhou University, Lanzhou, China.|Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China.
authors.forename: Yaolong
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.|Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China.|Chinese GRADE Center, Lanzhou University, Lanzhou, China.
authors.forename: Kehu
authors.initials: K
authors.lastname: Yang
keywords: Animal study; GRADE; systematic review