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. 2014;108(7):421-31.
doi: 10.1016/j.zefq.2014.08.004. Epub 2014 Sep 23.

[GRADE guidelines 15: going from evidence to recommendation - determinants of a recommendation's direction and strength]

[Article in German]
Barbara Nußbaumer  1 , Gerald Gartlehner  2 , Christina Kien  2 , Angela Kaminski-Hartenthaler  2 , Gero Langer  3 , Joerg J Meerpohl  4 , Holger J Schünemann  5
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[GRADE guidelines 15: going from evidence to recommendation - determinants of a recommendation's direction and strength]

[Article in German]
Barbara Nußbaumer et al. Z Evid Fortbild Qual Gesundhwes. 2014.

Abstract

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.

Keywords: Empfehlungen; Evidenz; GRADE; Leitlinienentwicklung; Qualität der Evidenz; Stärke der Evidenz; evidence; guideline development; quality of evidence; recommendation; strength of evidence.

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