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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)
The U.S. Preventive Services Task Force (USPSTF/Task Force) represents one of several efforts to take a more evidence-based approach to the development of clinical practice guidelines. As methods have matured for assembling and reviewing evidence and for translating evidence into guidelines, so too have the methods of the USPSTF. This paper summarizes the(More)
PURPOSE To synthesize new data on breast cancer screening for the U.S. Preventive Services Task Force. DATA SOURCES MEDLINE; the Cochrane Controlled Trials Registry; and reference lists of reviews, editorials, and original studies. STUDY SELECTION Eight randomized, controlled trials of mammography and 2 trials evaluating breast self-examination were(More)
BACKGROUND Recombinant human bone morphogenetic protein-2 (rhBMP-2) is used as a bone graft substitute in spinal fusion, which unites (fuses) bones in the spine. The accuracy and completeness of journal publications of industry-sponsored trials on the effectiveness and harms of rhBMP-2 has been called into question. PURPOSE To independently assess the(More)
CONTEXT Each year, approximately 5000 infants are born in the United States with moderate-to-profound, bilateral permanent hearing loss (PHL). Universal newborn hearing screening (UNHS) has been proposed as a means to speed diagnosis and treatment and thereby improve language outcomes in these children. OBJECTIVES To identify strengths, weaknesses, and(More)
OBJECTIVE To establish guidance on grading strength of evidence for the Evidence-based Practice Center (EPC) program of the U.S. Agency for Healthcare Research and Quality. STUDY DESIGN AND SETTING Authors reviewed authoritative systems for grading strength of evidence, identified domains and methods that should be considered when grading bodies of(More)
BACKGROUND Developmental dysplasia of the hip (DDH) represents a spectrum of anatomic abnormalities that can result in permanent disability. OBJECTIVE We sought to gather and synthesize the published evidence regarding screening for DDH by primary care providers. METHODS We performed a systematic review of the literature by using a best-evidence(More)
OBJECTIVE To evaluate the incidence and consequences of uterine rupture in women who have had a delivery by caesarean section. DESIGN Systematic review. DATA SOURCES Medline, HealthSTAR, Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, National Centre for Reviews and Dissemination, reference lists, and national experts.(More)
BACKGROUND C-reactive protein (CRP) may help to refine global risk assessment for coronary heart disease (CHD), particularly among persons who are at intermediate risk on the basis of traditional risk factors alone. PURPOSE To assist the U.S. Preventive Services Task Force (USPSTF) in determining whether CRP should be incorporated into guidelines for CHD(More)