GRADE在系统评价中应用的必要性及注意事项

Application of GRADE in Systematic Reviews:Necessity,Frequently-Asked Questions and Concerns

本文通过具体实例分析了为何需要在系统评价中应用GRADE分级的原因,以及在使用过程中可能存在的误区与注意事项,主要包括:如何区分指南和系统评价中GRADE的不同应用,如何确定总的证据质量分级,是否应对单个研究进行分级,RCT和观察性研究分级的差异,分级条目权重的考虑,升降级级数的考虑和可能影响GRADE分级结果的因素,以期为正确理解和应用GRADE分级提供一定参考。

We elaborated the reasons why systematic reviews need to use GRADE based on a couple of specific examples. Aiming to provide references to understand and use GRADE correctly, we also answered some frequently-asked questions and concerns about GRADE as follows： a） differentiating the uses of GRADE between its application in guidelines and in systematic reviews; b） how to determine the overall quality of evidence？ c） can GRADE be used to access the quality of single study or not？ d） different uses of GRADE between randomized controlled trials （RCTs） and observational studies; e） weight of GRADE items; and f） factors that might influence the results of GRADE and the balance between upgrading and downgrading.