Vanderbilt Evidence-based Practice Center, Vanderbilt University, #27166-719 Thompson Lane, Nashville, TN 37204-3195, USA.
J Clin Epidemiol. 2013 Jul;66(7):726-35. doi: 10.1016/j.jclinepi.2013.02.003. Epub 2013 Apr 6.
In the GRADE approach, the strength of a recommendation reflects the extent to which we can be confident that the composite desirable effects of a management strategy outweigh the composite undesirable effects. This article addresses GRADE's approach to determining the direction and strength of a recommendation. The GRADE describes the balance of desirable and undesirable outcomes of interest among alternative management strategies depending on four domains, namely estimates of effect for desirable and undesirable outcomes of interest, confidence in the estimates of effect, estimates of values and preferences, and resource use. Ultimately, guideline panels must use judgment in integrating these factors to make a strong or weak recommendation for or against an intervention.
在 GRADE 方法中，推荐的强度反映了我们有多大把握相信管理策略的综合理想效果超过综合不理想效果。本文介绍了 GRADE 确定推荐方向和强度的方法。GRADE 根据四个领域来描述替代管理策略的理想和不理想结果的平衡，即对感兴趣的理想和不理想结果的效应估计、对效应估计的信心、对价值观和偏好的估计以及资源利用。最终，指南小组必须运用判断来综合这些因素，以对干预措施做出支持或反对的强烈或微弱建议。
