GRADE 指南：Ⅰ. 導論—— GRADE 證據概要表和結果總結表△_《中國循證醫學雜志》

作者：

Gordon Guyatt，Andrew D. Oxman，Elie Akl，Regina Kunz，Gunn Vist，Jan Brozek，Susan Norris，Yngve Falck-Ytter，Paul Glasziou，Hans deBeer，Roman Jaeschke，David Rind，Joerg Meerpohl，Philipp Dahm，Holger J. Schünemann，代表GRADE工作組*;

關鍵詞：

GRADE 系統評價臨床實踐指南衛生技術評估證據質量推薦強度

DOI：

10.7507/1672-2531.20110076

視頻：

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本文是GRADE（Grading of Recommendations Assessment，Development，and Evaluation）系列文章的導論。該系列文章為使用GRADE系統提供指導，介紹如何將該系統用于系統評價、衛生技術評估（HTAs）及臨床實踐指南中備選方案的證據質量評價和推薦強度評級。GRADE方法始于提出一個明晰的問題，包括對所有重要結果的詳細說明。證據被收集和匯總后，GRADE提供了明確的標準來評價其質量，包括研究設計、偏倚風險、不精確性、不一致性、間接性及效應量大小。

引用本文： . GRADE 指南：Ⅰ. 導論—— GRADE 證據概要表和結果總結表△. 中國循證醫學雜志, 2011, 11(4): 437-445. doi: 10.7507/1672-2531.20110076 復制

1.	2 Schunemann HJ, Woodhead M, Anzueto A, et al . A vision statement on guideline development for respiratory disease: the example of COPD. Lancet , 2009, 373: 774-779.
2.	Field M, Lohr K. Clinical practice guidelines: directions for a new program. Washington, DC: National Academic Press; 1990.
3.	Guyatt G, Vist G, Falck-Ytter Y, et al . An emerging consensus on grading recommendations? ACP J Club , 2006, 144(1): A8-9.
4.	Guyatt GH, Oxman AD, Kunz R, et al . Incorporating considerations of resources use into grading recommendations. BMJ , 2008, 336: 1170-1173.
5.	Guyatt GH, Oxman AD, Vist GE, et al . GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ , 2008, 336: 924-926.
6.	Guyatt GH, Oxman AD, Kunz R, et al . What is ‘‘quality of evidence’’ and why is it important to clinicians? BMJ , 2008, 336: 995-998.
7.	Guyatt GH, Oxman AD, Kunz R, et al . Going from evidence to recommendations. BMJ , 2008, 336: 1049-1051.
8.	Schunemann HJ, Oxman AD, Brozek J, et al . Grading quality of evidence and strength of recommendations for diagnostic tests and strategies. BMJ , 2008, 336: 1106-1110.
9.	Jaeschke R, Guyatt GH, Dellinger P, et al . Use of GRADE grid to reach decisions on clinical practice guidelines when consensus is elusive. BMJ , 2008, 337: a744.
10.	Brozek J, Oxman A, Sch€unemann HJ. GRADEpro. [Computer program].Version 3.2 for Windows. Available at http://mcmaster.flintbox.com/technology.asp?Page53993 and http://www.cc-ims.net/revman/gradepro. Accessed October 21, 2010.
11.	Schünemann H, Brozek J, Guyatt G, et al . GRADE handbook for grading quality of evidence and strength of recommendation; 2010.
12.	Oxman AD, Sackett DL, Guyatt GH. Users’ guides to the medical literature.I. How to get started. The Evidence-Based Medicine Working Group. JAMA , 1993, 270: 2093-2095.
13.	Akl EA, Maroun N, Guyatt G, et al . Symbols were superior to numbers for presenting strength of recommendations to health care consumers: a randomized trial. J Clin Epidemiol , 2007, 60: 1298-1305.
14.	GRADE Working Group. Systems for grading the quality of evidence and the strength of recommendations II: Pilot study of a new system. BMC Health Serv Res , 2005, 5: 25.
15.	Rosenbaum SE, Glenton C, Nylund HK, et al . User testing and stakeholder feedback contributed to the development of understandable and useful Summary of Findings tables for Cochrane reviews. J Clin Epidemiol , 2010, 63: 607-619.
16.	Rosenbaum S, Glenton C, Oxman A. Evaluation of summary of findings tables for Cochrane reviews. J Clin Epidemiol , 2009.
17.	Schunemann H, Fretheim A, Oxman AD. Improving the use of research evidence in guideline development: 1. Guidelines for guidelines. Health Res Policy Syst , 2006, 4: 13.
18.	Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.0. [www.cochrane-handbook.org].
19.	Schünemann H, Fretheim A, Oxman AD. Improving the use of research evidence in guideline development: 9. Grading evidence and recommendations. Health Res Policy Syst , 2006, 4: 21.

1. 2 Schunemann HJ, Woodhead M, Anzueto A, et al . A vision statement on guideline development for respiratory disease: the example of COPD. Lancet , 2009, 373: 774-779.
2. Field M, Lohr K. Clinical practice guidelines: directions for a new program. Washington, DC: National Academic Press; 1990.
3. Guyatt G, Vist G, Falck-Ytter Y, et al . An emerging consensus on grading recommendations? ACP J Club , 2006, 144(1): A8-9.
4. Guyatt GH, Oxman AD, Kunz R, et al . Incorporating considerations of resources use into grading recommendations. BMJ , 2008, 336: 1170-1173.
5. Guyatt GH, Oxman AD, Vist GE, et al . GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ , 2008, 336: 924-926.
6. Guyatt GH, Oxman AD, Kunz R, et al . What is ‘‘quality of evidence’’ and why is it important to clinicians? BMJ , 2008, 336: 995-998.
7. Guyatt GH, Oxman AD, Kunz R, et al . Going from evidence to recommendations. BMJ , 2008, 336: 1049-1051.
8. Schunemann HJ, Oxman AD, Brozek J, et al . Grading quality of evidence and strength of recommendations for diagnostic tests and strategies. BMJ , 2008, 336: 1106-1110.
9. Jaeschke R, Guyatt GH, Dellinger P, et al . Use of GRADE grid to reach decisions on clinical practice guidelines when consensus is elusive. BMJ , 2008, 337: a744.
10. Brozek J, Oxman A, Sch€unemann HJ. GRADEpro. [Computer program].Version 3.2 for Windows. Available at http://mcmaster.flintbox.com/technology.asp?Page53993 and http://www.cc-ims.net/revman/gradepro. Accessed October 21, 2010.
11. Schünemann H, Brozek J, Guyatt G, et al . GRADE handbook for grading quality of evidence and strength of recommendation; 2010.
12. Oxman AD, Sackett DL, Guyatt GH. Users’ guides to the medical literature.I. How to get started. The Evidence-Based Medicine Working Group. JAMA , 1993, 270: 2093-2095.
13. Akl EA, Maroun N, Guyatt G, et al . Symbols were superior to numbers for presenting strength of recommendations to health care consumers: a randomized trial. J Clin Epidemiol , 2007, 60: 1298-1305.
14. GRADE Working Group. Systems for grading the quality of evidence and the strength of recommendations II: Pilot study of a new system. BMC Health Serv Res , 2005, 5: 25.
15. Rosenbaum SE, Glenton C, Nylund HK, et al . User testing and stakeholder feedback contributed to the development of understandable and useful Summary of Findings tables for Cochrane reviews. J Clin Epidemiol , 2010, 63: 607-619.
16. Rosenbaum S, Glenton C, Oxman A. Evaluation of summary of findings tables for Cochrane reviews. J Clin Epidemiol , 2009.
17. Schunemann H, Fretheim A, Oxman AD. Improving the use of research evidence in guideline development: 1. Guidelines for guidelines. Health Res Policy Syst , 2006, 4: 13.
18. Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.0. [www.cochrane-handbook.org].
19. Schünemann H, Fretheim A, Oxman AD. Improving the use of research evidence in guideline development: 9. Grading evidence and recommendations. Health Res Policy Syst , 2006, 4: 21.

《中國循證醫學雜志》

GRADE 指南：Ⅰ. 導論—— GRADE 證據概要表和結果總結表△

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《中國循證醫學雜志》

GRADE 指南：Ⅰ. 導論—— GRADE 證據概要表和結果總結表△

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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