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Advances in the GRADE approach to rate the certainty in estimates from a network meta-analysis

Authordc.contributor.authorBrignardello Petersen, Romina 
Authordc.contributor.authorBonner, Ashley 
Authordc.contributor.authorAlexander, Paul 
Authordc.contributor.authorSiemieniuk, Reed 
Authordc.contributor.authorFurukawa, Toshi 
Authordc.contributor.authorRochwerg, Bram 
Authordc.contributor.authorHazlewood, Glen 
Authordc.contributor.authorAlhazzani, Waleed 
Authordc.contributor.authorMustafa, Reem 
Authordc.contributor.authorMurad, M. Hassan 
Authordc.contributor.authorPuhan, Milo 
Authordc.contributor.authorSch€unemann, Holger 
Authordc.contributor.authorGuyatt, Gordon H. 
Cita de ítemdc.identifier.citationJournal of Clinical Epidemiology 93 (2018) 36-44es_ES
Abstractdc.description.abstractThis article describes conceptual advances of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) working group guidance to evaluate the certainty of evidence (confidence in evidence, quality of evidence) from network meta-analysis (NMA). Application of the original GRADE guidance, published in 2014, in a number of NMAs has resulted in advances that strengthen its conceptual basis and make the process more efficient. This guidance will be useful for systematic review authors who aim to assess the certainty of all pairwise comparisons from an NMA and who are familiar with the basic concepts of NMA and the traditional GRADE approach for pairwise meta-analysis. Two principles of the original GRADE NMA guidance are that we need to rate the certainty of the evidence for each pairwise comparison within a network separately and that in doing so we need to consider both the direct and indirect evidence. We present, discuss, and illustrate four conceptual advances: (1) consideration of imprecision is not necessary when rating the direct and indirect estimates to inform the rating of NMA estimates, (2) there is no need to rate the indirect evidence when the certainty of the direct evidence is high and the contribution of the direct evidence to the network estimate is at least as great as that of the indirect evidence, (3) we should not trust a statistical test of global incoherence of the network to assess incoherence at the pairwise comparison level, and (4) in the presence of incoherence between direct and indirect evidence, the certainty of the evidence of each estimate can help decide which estimate to believees_ES
Type of licensedc.rightsAttribution-NonCommercial-NoDerivs 3.0 Chile*
Link to Licensedc.rights.uri*
Sourcedc.sourceJournal of Clinical Epidemiologyes_ES
Keywordsdc.subjectQuality of evidencees_ES
Keywordsdc.subjectNetwork meta-analysises_ES
Keywordsdc.subjectIndirect comparisonses_ES
Keywordsdc.subjectCertainty of evidencees_ES
Keywordsdc.subjectConfidence in estimates of effectes_ES
Títulodc.titleAdvances in the GRADE approach to rate the certainty in estimates from a network meta-analysises_ES
Document typedc.typeArtículo de revistaes_ES
Indexationuchile.indexArtículo de publicación ISIes_ES

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Except where otherwise noted, this item's license is described as Attribution-NonCommercial-NoDerivs 3.0 Chile