When authors of systematic reviews utilize the GRADE approach to evaluate the certainty of evidence in their findings, they should present this information in a way that is clear, consistent, and useful to the reader. In a recent article from the GRADE series (GRADE guidelines 26) in the Journal of Clinical Epidemiology, Santesso and colleagues present recommendations for communicating the effect size and certainty of evidence within a systematic review. These statements were informed by years of research, feedback, and discussion, including the qualitative input of around 100 methodology experts and a survey of 110 respondents of diverse backgrounds and levels of GRADE expertise.
The final result was a table of suggested statements organized by the certainty of the effect followed by the size of that effect based on the point estimate. In order to use this tool, systematic review authors will need to first determine thresholds for the size of the effect (i.e., whether the effect on an outcome is trivial, small, moderate, or large, or if there is no effect). This can be accomplished in “full contextualization,” in which the outcome is considered in relation to all other critical outcomes, or “partial contextualization,” in relation to the standalone value of the single outcome.
The suggested statements generated from the table can be used throughout the text of a systematic review, from the abstract to the discussion, and as part of any review type, such as those examining the accuracy of test strategies. The included language is also simple enough to be included as part of a plain language summary or other consumer-facing materials.
Santesso N, Glenton C, Dahm P, Garner P, Akl E, Alper B, Brignardello-Petersen R, Carrasco-Labra A, De Beer H, Hultcrantz M, Kuijpers T Meerpohl J, Morgan R, Mustafa R, Skoetz N, Sultan S, Wiysonge C, Guyatt G, Schünemann HJ. GRADE guidelines 26: Informative statements to communicate the findings of systematic reviews of interventions. Journal of clinical epidemiology. 2019 Nov 9.
The suggested statements generated from the table can be used throughout the text of a systematic review, from the abstract to the discussion, and as part of any review type, such as those examining the accuracy of test strategies. The included language is also simple enough to be included as part of a plain language summary or other consumer-facing materials.
Santesso N, Glenton C, Dahm P, Garner P, Akl E, Alper B, Brignardello-Petersen R, Carrasco-Labra A, De Beer H, Hultcrantz M, Kuijpers T Meerpohl J, Morgan R, Mustafa R, Skoetz N, Sultan S, Wiysonge C, Guyatt G, Schünemann HJ. GRADE guidelines 26: Informative statements to communicate the findings of systematic reviews of interventions. Journal of clinical epidemiology. 2019 Nov 9.
Manuscript available here on publisher's site.
