Grading quality of evidence and strength of recommendations in clinical practice guidelines: Part 2 of 3. The GRADE approach to grading quality of evidence about diagnostic tests and strategies

@article{Broek2009GradingQO,
  title={Grading quality of evidence and strength of recommendations in clinical practice guidelines: Part 2 of 3. The GRADE approach to grading quality of evidence about diagnostic tests and strategies},
  author={Jan L. Brożek and Elie A. Akl and Roman Z. Jaeschke and D M Lang and Patrick M. M. Bossuyt and Paul P. Glasziou and Mark Helfand and Erin Ueffing and Pablo Alonso-Coello and Joerg J. Meerpohl and Bob Phillips and Andrea Rita Horvath and Jean Bousquet and Gordon H. Guyatt and Holger J. Schünemann},
  journal={Allergy},
  year={2009},
  volume={64}
}
The GRADE approach to grading the quality of evidence and strength of recommendations provides a comprehensive and transparent approach for developing clinical recommendations about using diagnostic tests or diagnostic strategies. Although grading the quality of evidence and strength of recommendations about using tests shares the logic of grading recommendations for treatment, it presents unique challenges. Guideline panels and clinicians should be alert to these special challenges when using… 

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References

SHOWING 1-10 OF 28 REFERENCES

Grading quality of evidence and strength of recommendations in clinical practice guidelines

This first article in a three‐part series describes the GRADE framework in relation to grading the quality of evidence about interventions based on examples from the field of allergy and asthma.

Grading quality of evidence and strength of recommendations for diagnostic tests and strategies.

This commentary provides a brief overview of the principles for assessing the strength of evidence and the challenges guideline developers face in formulating graded recommendations related to the use of laboratory tests.

Assessing quality of a diagnostic test evaluation

A 19-item weighted scale is proposed as a useful instrument for readers, investigators, reviewers, and editors, because it represents an updated synthesis of important criteria to consider when evaluating diagnostic tests.

When Is Measuring Sensitivity and Specificity Sufficient To Evaluate a Diagnostic Test, and When Do We Need Randomized Trials?

A practical framework to help clinicians decide whether a new diagnostic test can be adopted on the basis of evidence of test accuracy alone or if they need to wait for results from randomized trials is provided.

The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews

The aim of this project was to combine empirical evidence and expert opinion in a formal consensus method to develop a tool to be used in systematic reviews to assess the quality of primary studies of diagnostic accuracy.

Towards complete and accurate reporting of studies of diagnostic accuracy: the STARD initiative

If medical journals adopt the STARD checklist and flow diagram, the quality of reporting of studies of diagnostic accuracy should improve to the advantage of clinicians, researchers, reviewers, journals, and the public.

The STARD Statement for Reporting Studies of Diagnostic Accuracy: Explanation and Elaboration

The STARD project group has developed a single-page checklist, which contains a clarification of the meaning, rationale, and optimal use of each item on the checklist, as well as a short summary of the available evidence on bias and applicability.

Evaluation of diagnostic procedures

The methodology of diagnostic research lags far behind that for evaluating treatments, and overcoming deficiencies in standards, methodology, and funding deserves high priority.

The STARD Statement for Reporting Diagnostic Accuracy Studies: Application to the History and Physical Examination

The STARD statement provides a very useful framework for diagnostic accuracy studies and should enhance their usefulness to investigators embarking on original studies of a patient’s history and physical examination.