GRADE guidelines 26: informative statements to communicate the findings of systematic reviews of interventions

doi:10.1016/j.jclinepi.2019.10.014

. 2020 Mar:119:126-135.

doi: 10.1016/j.jclinepi.2019.10.014. Epub 2019 Nov 9.

GRADE guidelines 26: informative statements to communicate the findings of systematic reviews of interventions

Nancy Santesso¹, Claire Glenton², Philipp Dahm³, Paul Garner⁴, Elie A Akl⁵, Brian Alper⁶, Romina Brignardello-Petersen⁷, Alonso Carrasco-Labra⁷, Hans De Beer⁸, Monica Hultcrantz⁹, Ton Kuijpers¹⁰, Joerg Meerpohl¹¹, Rebecca Morgan⁷, Reem Mustafa¹², Nicole Skoetz¹³, Shahnaz Sultan¹⁴, Charles Wiysonge¹⁵, Gordon Guyatt¹⁶, Holger J Schünemann¹⁶; GRADE Working Group

Affiliations

¹ Department of Health Research Methods, Evidence and Impact, Cochrane Canada, MacGRADE Centre and Michael G. DeGroote Cochrane Canada Centre, McMaster University, 1280 Main St East, Hamilton, L8S 4L8, Canada. Electronic address: santesna@mcmaster.ca.
² Cochrane Norway and the Informed Health Choices Research Centre, Norwegian Institute of Public Health, Postboks 222 Skøyen, Sandakerveien 24C, inngang D11, 0213, Oslo, Norway.
³ Minneapolis VA Health Care System, Urology Section 112D, One Veterans Drive, Minneapolis, MN, 55417, USA.
⁴ Centre for Evidence Synthesis in Global Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
⁵ Department of Internal Medicine, American University of Beirut, P.O.Box 11-0236, Lebanon.
⁶ EBSCO Health, Innovations and Evidence-Based Medicine Development, 10 Estes Street, Ipswich, MA, 01938, USA; Department of Family and Community Medicine, University of Missouri-Columbia, Columbia, MO, USA.
⁷ Department of Health Research Methods, Evidence and Impact, Cochrane Canada, MacGRADE Centre and Michael G. DeGroote Cochrane Canada Centre, McMaster University, 1280 Main St East, Hamilton, L8S 4L8, Canada.
⁸ Guide2Guidance, Lemelerberg 7, 3524 LC Utrecht, the Netherlands.
⁹ Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU), S:t Eriksgatan 117, SE-102 33, Stockholm, Sweden.
¹⁰ Department of Guideline Development and Research, Dutch College of General Practitioners (NHG), Mercatorlaan 1200, 3528, BL, Utrecht, the Netherlands.
¹¹ Institute for Evidence in Medicine, Breisacher Strasse 153, 79110, Freiburg, Germany.
¹² Department of Health Research Methods, Evidence and Impact, Cochrane Canada, MacGRADE Centre and Michael G. DeGroote Cochrane Canada Centre, McMaster University, 1280 Main St East, Hamilton, L8S 4L8, Canada; Division of Nephrology and Hypertension, Department of Internal Medicine, University of Kansas Medical Center, 3901 Rainbow Blvd, MS3002, Kansas City, KS, 66160, USA.
¹³ Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, University of Cologne, Kerpener Str. 62, 50931, Cologne, Germany.
¹⁴ Division of Gastroenterology and Hepatology, and Nutrition, University of Minnesota, Minneapolis Veterans Affairs Healthcare System, 516 Delaware St. SE, 1st Floor, Phillips-Wangsteen Building, MMC 36, Minneapolis, MN, 55455, USA.
¹⁵ Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa; School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa; Department of Global Health, Stellenbosch University, Cape Town, South Africa; Cochrane South Africa, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, 7501, Cape Town, South Africa.
¹⁶ Department of Health Research Methods, Evidence and Impact, Cochrane Canada, MacGRADE Centre and Michael G. DeGroote Cochrane Canada Centre, McMaster University, 1280 Main St East, Hamilton, L8S 4L8, Canada; Department of Medicine, McMaster University, 1280, Main St East, L8S 4L8, Hamilton, Canada.

PMID: 31711912
DOI: 10.1016/j.jclinepi.2019.10.014

Free article

GRADE guidelines 26: informative statements to communicate the findings of systematic reviews of interventions

Nancy Santesso et al. J Clin Epidemiol. 2020 Mar.

Free article

. 2020 Mar:119:126-135.

doi: 10.1016/j.jclinepi.2019.10.014. Epub 2019 Nov 9.

Authors

Affiliations

¹ Department of Health Research Methods, Evidence and Impact, Cochrane Canada, MacGRADE Centre and Michael G. DeGroote Cochrane Canada Centre, McMaster University, 1280 Main St East, Hamilton, L8S 4L8, Canada. Electronic address: santesna@mcmaster.ca.
² Cochrane Norway and the Informed Health Choices Research Centre, Norwegian Institute of Public Health, Postboks 222 Skøyen, Sandakerveien 24C, inngang D11, 0213, Oslo, Norway.
³ Minneapolis VA Health Care System, Urology Section 112D, One Veterans Drive, Minneapolis, MN, 55417, USA.
⁴ Centre for Evidence Synthesis in Global Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
⁵ Department of Internal Medicine, American University of Beirut, P.O.Box 11-0236, Lebanon.
⁶ EBSCO Health, Innovations and Evidence-Based Medicine Development, 10 Estes Street, Ipswich, MA, 01938, USA; Department of Family and Community Medicine, University of Missouri-Columbia, Columbia, MO, USA.
⁷ Department of Health Research Methods, Evidence and Impact, Cochrane Canada, MacGRADE Centre and Michael G. DeGroote Cochrane Canada Centre, McMaster University, 1280 Main St East, Hamilton, L8S 4L8, Canada.
⁸ Guide2Guidance, Lemelerberg 7, 3524 LC Utrecht, the Netherlands.
⁹ Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU), S:t Eriksgatan 117, SE-102 33, Stockholm, Sweden.
¹⁰ Department of Guideline Development and Research, Dutch College of General Practitioners (NHG), Mercatorlaan 1200, 3528, BL, Utrecht, the Netherlands.
¹¹ Institute for Evidence in Medicine, Breisacher Strasse 153, 79110, Freiburg, Germany.
¹² Department of Health Research Methods, Evidence and Impact, Cochrane Canada, MacGRADE Centre and Michael G. DeGroote Cochrane Canada Centre, McMaster University, 1280 Main St East, Hamilton, L8S 4L8, Canada; Division of Nephrology and Hypertension, Department of Internal Medicine, University of Kansas Medical Center, 3901 Rainbow Blvd, MS3002, Kansas City, KS, 66160, USA.
¹³ Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, University of Cologne, Kerpener Str. 62, 50931, Cologne, Germany.
¹⁴ Division of Gastroenterology and Hepatology, and Nutrition, University of Minnesota, Minneapolis Veterans Affairs Healthcare System, 516 Delaware St. SE, 1st Floor, Phillips-Wangsteen Building, MMC 36, Minneapolis, MN, 55455, USA.
¹⁵ Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa; School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa; Department of Global Health, Stellenbosch University, Cape Town, South Africa; Cochrane South Africa, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, 7501, Cape Town, South Africa.
¹⁶ Department of Health Research Methods, Evidence and Impact, Cochrane Canada, MacGRADE Centre and Michael G. DeGroote Cochrane Canada Centre, McMaster University, 1280 Main St East, Hamilton, L8S 4L8, Canada; Department of Medicine, McMaster University, 1280, Main St East, L8S 4L8, Hamilton, Canada.

PMID: 31711912
DOI: 10.1016/j.jclinepi.2019.10.014

Abstract

Objectives: Clear communication of systematic review findings will help readers and decision makers. We built on previous work to develop an approach that improves the clarity of statements to convey findings and that draws on Grading of Recommendations Assessment, Development and Evaluation (GRADE).

Study design and setting: We conducted workshops including 80 attendants and a survey of 110 producers and users of systematic reviews. We calculated acceptability of statements and revised the wording of those that were unacceptable to ≥40% of participants.

Results: Most participants agreed statements should be based on size of effect and certainty of evidence. Statements for low, moderate and high certainty evidence were acceptable to >60%. Key guidance, for example, includes statements for high, moderate and low certainty for a large effect on intervention x as: x results in a large reduction…; x likely results in a large reduction…; x may result in a large reduction…, respectively.

Conclusions: Producers and users of systematic reviews found statements to communicate findings combining size and certainty of an effect acceptable. This article provides GRADE guidance and a wording template to formulate statements in systematic reviews and other decision tools.

Keywords: Evidence-based Medicine; Health communication; Language; Persuasive communication; Review literature as topic; Surveys and Questionnaires.

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GRADE guidelines 26: informative statements to communicate the findings of systematic reviews of interventions

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GRADE guidelines 26: informative statements to communicate the findings of systematic reviews of interventions

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