Brozek J L, Akl E A, Alonso-Coello P, Lang D, Jaeschke R, Williams J W, Phillips B, Lelgemann M, Lethaby A, Bousquet J, Guyatt G H, Schünemann H J
Department of Epidemiology, Italian National Cancer Institute Regina Elena, Rome, Italy.
Allergy. 2009 May;64(5):669-77. doi: 10.1111/j.1398-9995.2009.01973.x.
The GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) approach provides guidance to grading the quality of underlying evidence and the strength of recommendations in health care. The GRADE system's conceptual underpinnings allow for a detailed stepwise process that defines what role the quality of the available evidence plays in the development of health care recommendations. The merit of GRADE is not that it eliminates judgments or disagreements about evidence and recommendations, but rather that it makes them transparent. This first article in a three-part series describes the GRADE framework in relation to grading the quality of evidence about interventions based on examples from the field of allergy and asthma. In the GRADE system, the quality of evidence reflects the extent to which a guideline panel's confidence in an estimate of the effect is adequate to support a particular recommendation. The system classifies quality of evidence as high, moderate, low, or very low according to factors that include the study methodology, consistency and precision of the results, and directness of the evidence.
推荐分级评估、制定与评价（GRADE）方法为医疗保健中基础证据的质量分级和推荐强度提供指导。GRADE系统的概念基础允许采用详细的逐步流程，该流程定义了现有证据的质量在医疗保健推荐制定过程中所起的作用。GRADE的优点并非在于它消除了对证据和推荐的判断或分歧，而是在于它使这些判断和分歧变得透明。这个三篇系列文章中的第一篇基于过敏和哮喘领域的实例，描述了与干预措施证据质量分级相关的GRADE框架。在GRADE系统中，证据质量反映了指南小组对效应估计的信心足以支持特定推荐的程度。该系统根据包括研究方法、结果的一致性和精确性以及证据的直接性等因素，将证据质量分为高、中、低或极低。
