Rating the certainty in evidence in the absence of a single estimate of effect.
When studies measure or report outcomes differently, it may not be feasible to pool data across studies to generate a single effect estimate (ie, perform meta-analysis). Instead, only a narrative summary of the effect across different studies might be available. Regardless of whether a single pooled effect estimate is generated or whether data are summarised narratively, decision makers need to know the certainty in the evidence in order to make informed decisions. In this guide, we illustrate how to apply the constructs of the GRADE (Grading of Recommendation, Assessment, Development and Evaluation) approach to assess the certainty in evidence when a meta-analysis has not been performed and data were summarised narratively.
Evidence-based Practice Center, Mayo Clinic, Rochester, Minnesota, USA.
M Hassan
MH
Murad
Department of Biomedical and Health Informatics, University of Missouri-Kansas City, Kansas City, Missouri, USA.|Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
Reem A
RA
Mustafa
Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
Holger J
HJ
Schünemann
Division of Gastroenterology, Department of Medicine, University of Minnesota, and Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA.
Shahnaz
S
Sultan
Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
Nancy
N
Santesso
D000066491:Clinical Decision-Making; D003657:Decision Making; D019317:Evidence-Based Medicine / Q000592:standards*; D017408:Guidelines as Topic; D006291:Health Policy; D006801:Humans; D035501:Uncertainty
EPIDEMIOLOGY; STATISTICS & RESEARCH METHODS