Kaminski-Hartenthaler Angela, Meerpohl Joerg J, Gartlehner Gerald, Kien Christina, Langer Gero, Wipplinger Jörg, Schünemann Holger J
Donau-Universität Krems, Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Krems, Österreich.
Deutsches Cochrane Zentrum, Universitätsklinikum Freiburg, Freiburg, Deutschland.
Z Evid Fortbild Qual Gesundhwes. 2014;108(7):413-20. doi: 10.1016/j.zefq.2014.08.003. Epub 2014 Sep 16.
This article describes the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to classifying the direction and strength of recommendations. The strength of a recommendation, separated into strong and weak, is defined as the extent to which one can be confident that the desirable effects of an intervention outweigh its undesirable effects. Alternative terms for a weak recommendation include conditional, discretionary, or qualified. The strength of a recommendation has specific implications for patients, the public, clinicians, and policy makers. Occasionally, guideline developers may choose to make "only-in-research" recommendations. Although panels may choose not to make recommendations, this choice leaves those looking for answers from guidelines without the guidance they are seeking. GRADE therefore encourages panels to, wherever possible, offer recommendations.
本文描述了推荐分级评估、制定与评价(GRADE)方法,用于对推荐的方向和强度进行分类。推荐强度分为强推荐和弱推荐,其定义为人们能够确信一项干预措施的有益效果超过其有害效果的程度。弱推荐的其他表述包括有条件的、酌情的或限定性的。推荐强度对患者、公众、临床医生和政策制定者具有特定影响。偶尔,指南制定者可能会选择做出“仅用于研究”的推荐。尽管专家组可能选择不给出推荐,但这种选择会使那些从指南中寻求答案的人得不到他们所期望的指导。因此,GRADE鼓励专家组尽可能提供推荐。