Applying Grading of Recommendations Assessment, Development and Evaluation (GRADE) to diagnostic tests was challenging but doable.
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Applying Grading of Recommendations Assessment, Development and Evaluation (GRADE) to diagnostic tests was challenging but doable. / Gopalakrishna, G; Mustafa, Reem; Davenport, Clare; Scholten, Rob JPM; Hyde, CJ; Brozek, J; Schunemann, H; Bossuyt, PMM; Leeflang, MMG; Langendam, MW.
In: Journal of Clinical Epidemiology, Vol. 67, No. 7, 07.2014, p. 760-768.Research output: Contribution to journal › Article › peer-review
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TY - JOUR
T1 - Applying Grading of Recommendations Assessment, Development and Evaluation (GRADE) to diagnostic tests was challenging but doable.
AU - Gopalakrishna, G
AU - Mustafa, Reem
AU - Davenport, Clare
AU - Scholten, Rob JPM
AU - Hyde, CJ
AU - Brozek, J
AU - Schunemann, H
AU - Bossuyt, PMM
AU - Leeflang, MMG
AU - Langendam, MW
PY - 2014/7
Y1 - 2014/7
N2 - ObjectivesThe Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group developed an approach to assess the quality of evidence of diagnostic tests. Its use in Cochrane diagnostic test accuracy reviews is new. We applied this approach to three Cochrane reviews with the aim of better understanding the application of the GRADE criteria to such reviews.Study Design and SettingWe selected reviews to achieve clinical and methodological diversities. At least three assessors independently assessed each review according to the GRADE criteria of risk of bias, indirectness, imprecision, inconsistency, and publication bias. Two teleconferences were held to share experiences.ResultsFor the interpretation of the GRADE criteria, it made a difference whether assessors looked at the evidence from a patient-important outcome perspective or from a test accuracy standpoint. GRADE criteria such as inconsistency, imprecision, and publication bias were challenging to apply as was the assessment of comparative test accuracy reviews.ConclusionThe perspective from which evidence is graded can influence judgments about quality. Guidance on application of GRADE to comparative test reviews and on the GRADE criteria of inconsistency, imprecision, and publication bias will facilitate the operationalization of GRADE for diagnostics.
AB - ObjectivesThe Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group developed an approach to assess the quality of evidence of diagnostic tests. Its use in Cochrane diagnostic test accuracy reviews is new. We applied this approach to three Cochrane reviews with the aim of better understanding the application of the GRADE criteria to such reviews.Study Design and SettingWe selected reviews to achieve clinical and methodological diversities. At least three assessors independently assessed each review according to the GRADE criteria of risk of bias, indirectness, imprecision, inconsistency, and publication bias. Two teleconferences were held to share experiences.ResultsFor the interpretation of the GRADE criteria, it made a difference whether assessors looked at the evidence from a patient-important outcome perspective or from a test accuracy standpoint. GRADE criteria such as inconsistency, imprecision, and publication bias were challenging to apply as was the assessment of comparative test accuracy reviews.ConclusionThe perspective from which evidence is graded can influence judgments about quality. Guidance on application of GRADE to comparative test reviews and on the GRADE criteria of inconsistency, imprecision, and publication bias will facilitate the operationalization of GRADE for diagnostics.
KW - GRADE
KW - Cochrane diagnostic test accuracy systematic reviews
KW - Diagnostic test accuracy
KW - Diagnostics
KW - Systematic reviews
KW - Medical tests
U2 - 10.1016/j.jclinepi.2014.01.006
DO - 10.1016/j.jclinepi.2014.01.006
M3 - Article
VL - 67
SP - 760
EP - 768
JO - Journal of Clinical Epidemiology
JF - Journal of Clinical Epidemiology
SN - 0895-4356
IS - 7
ER -