Meader Nick, King Kristel, Llewellyn Alexis, Norman Gill, Brown Jennifer, Rodgers Mark, Moe-Byrne Thirimon, Higgins Julian Pt, Sowden Amanda, Stewart Gavin
Centre for Reviews and Dissemination, University of York, York YO10 5DD, UK.
Syst Rev. 2014 Jul 24;3:82. doi: 10.1186/2046-4053-3-82.
The grading of recommendation, assessment, development and evaluation (GRADE) approach is widely implemented in health technology assessment and guideline development organisations throughout the world. GRADE provides a transparent approach to reaching judgements about the quality of evidence on the effects of a health care intervention, but is complex and therefore challenging to apply in a consistent manner.
We developed a checklist to guide the researcher to extract the data required to make a GRADE assessment. We applied the checklist to 29 meta-analyses of randomised controlled trials on the effectiveness of health care interventions. Two reviewers used the checklist for each paper and used these data to rate the quality of evidence for a particular outcome.
For most (70%) checklist items, there was good agreement between reviewers. The main problems were for items relating to indirectness where considerable judgement is required.
There was consistent agreement between reviewers on most items in the checklist. The use of this checklist may be an aid to improving the consistency and reproducibility of GRADE assessments, particularly for inexperienced users or in rapid reviews without the resources to conduct assessments by two researchers independently.
推荐分级、评估、制定与评价（GRADE）方法在全球卫生技术评估和指南制定组织中广泛应用。GRADE提供了一种透明的方法来判断关于医疗保健干预效果的证据质量，但该方法复杂，因此难以以一致的方式应用。
我们制定了一份清单，以指导研究人员提取进行GRADE评估所需的数据。我们将该清单应用于29项关于医疗保健干预效果的随机对照试验的荟萃分析。两位评审员对每篇论文使用该清单，并利用这些数据对特定结果的证据质量进行评分。
对于大多数（70%）清单项目，评审员之间有良好的一致性。主要问题在于与间接性相关的项目，这些项目需要大量的判断。
评审员在清单的大多数项目上达成了一致。使用该清单可能有助于提高GRADE评估的一致性和可重复性，特别是对于缺乏经验的用户或在没有资源由两名研究人员独立进行评估的快速综述中。
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