Gunn Elisabeth Vist

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advantages and disadvantages but also by their confidence in these estimates. The cartoon depicting the weather forecaster’s uncertainty captures the difference between an assessment of the likelihood of an outcome and the confidence in that assessment (figure). The usefulness of an estimate of the magnitude of intervention effects depends on our confidence(More)
This article introduces the approach of GRADE to rating quality of evidence. GRADE specifies four categories-high, moderate, low, and very low-that are applied to a body of evidence, not to individual studies. In the context of a systematic review, quality reflects our confidence that the estimates of the effect are correct. In the context of(More)
OBJECTIVES The empirical basis for theories and common wisdom regarding how to improve appropriate use of research evidence in policy decisions is unclear. One source of empirical evidence is interview studies with policy-makers. The aim of this systematic review was to summarise the evidence from interview studies of facilitators of, and barriers to, the(More)
In the GRADE approach, randomized trials start as high-quality evidence and observational studies as low-quality evidence, but both can be rated down if most of the relevant evidence comes from studies that suffer from a high risk of bias. Well-established limitations of randomized trials include failure to conceal allocation, failure to blind, loss to(More)
Faced with the plethora of new diagnostic and therapeutic interventions, busy physicians need clear guidance on the best approaches to follow for their patients. This need has led to such a proliferation of practice guidelines (PGs) that for diabetes mellitus alone, for example, more than 150 guidelines are available worldwide. In the “jungle” of PGs, many(More)
BACKGROUND A number of approaches have been used to grade levels of evidence and the strength of recommendations. The use of many different approaches detracts from one of the main reasons for having explicit approaches: to concisely characterise and communicate this information so that it can easily be understood and thereby help people make well-informed(More)
This article describes the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to classifying the direction and strength of recommendations. The strength of a recommendation, separated into strong and weak, is defined as the extent to which one can be confident that the desirable effects of an intervention outweigh its(More)
Emerging health problems require rapid advice. We describe the development and pilot testing of a systematic, transparent approach used by the World Health Organization (WHO) to develop rapid advice guidelines in response to requests from member states confronted with uncertainty about the pharmacological management of avian influenza A (H5N1) virus(More)