To develop approaches, strategies, and guidance that support the dissemination of Cochrane Reviews and their use by a wide range of audience with specific focus on developers of recommendations (including guidance, guidelines, policies) and on healthcare decision makers (e.g. clinicians, policy makers).
Specifically, the Cochrane GRADEing provides guidance to optimize the usefulness of Cochrane Reviews by articulating reasons for grading the quality of the evidence and factors to consider when moving from evidence to recommendations.
Given Cochrane’s endorsement of GRADE (Grading of Recommendations Assessment, Development and Evaluation) and the desirability of uniform approaches to rating confidence in estimates, Cochrane GRADEing facilitates the dissemination and use of GRADE.
The group also provides detailed guidance to authors of Cochrane Reviews on how to apply the factors, and to users of Cochrane Reviews on how to interpret the judgments made by review authors. This includes guidance on providing the systematic review audience with the information necessary to make judgments about applicability and on making direct statements about applicability.
Applicability (also referred to as transferability, generalizability, and external validity) refers to whether or not available research evidence can be directly utilized to answer the health and health care question at hand, ideally supported by a judgment about the degree of confidence for this utilization. This broad definition of applicability is consistent with directness in the GRADE approach.
The Cochrane GRADEing also takes responsibility for training the editorial teams of Cochrane Review Groups and review authors to enable the development of SoF tables. Members of the Cochrane GRADEing conduct research on the applicability and the presentation of evidence. In addition, the group disseminates relevant research conducted by its members and other investigators.
Co-convenors: Holger Schünemann and Gordon Guyatt
|Dr. Holger Schünemann is chair of the Department of Clinical Epidemiology and Biostatistics at McMaster University, widely considered the birthplace of evidence-based medicine. He trained in internal medicine, epidemiology and preventive medicine. Having contributed to over 400 peer-reviewed publications (across a broad area of health care questions) he is co-chair of the GRADE working group, co-director of the World Health Organization (WHO) collaborating center for evidence informed policy-making, a member of the Board of Trustees of the Guideline International Network, the Cochrane Collaboration Steering Group, and several other committees. He led or participated in numerous high profile guideline panels, including at the WHO, the American College of Physicians, American Thoracic Society, the World Allergy Organization and he was a key contributor to the revised methods for WHO guideline development in 2006. For the past 15 years, he has been advisor to ministries of health and other governmental organizations for their guideline programs. His work also focuses on practical application of his work by researchers and clinicians through contributions to the guideline development tool (www.gradepro.org), the guideline checklist (cebgrade.mcmaster.ca/guidecheck.html) and GRADE evidence to decision frameworks (www.decide-collaboration.eu). Maintaining an active clinical practice fulfills his passion for patient care and ensures his research is people-oriented.|
|Dr. Gordon Guyatt is a Distinguished Professor in the Departments of Medicine and Clinical Epidemiology and Biostatistics at McMaster University. He has published over 1,000 papers in peer-reviewed journals; his work has been cited over 75,000 times. In 1990, he coined the term ‘evidence-based medicine’ and has since provided leadership in developing the methods for evidence-based clinical decision making. He has advanced methods of health status measurement, clinical trials, systematic review methods, and guideline development. He has played a major role in the creation and refinement of the GRADE approach to rating quality of evidence and grading strength of recommendations.|
Carlos Cuello Garcia
Maria Ximena Rojas-Reyes
The Cochrane GRADEing does not receive direct funding, but many of our research projects are funded by the Cochrane Methods Innovation Fund competitions.
Following an exploratory meeting in 1995 at the Cochrane Colloquium in Oslo, the ARMG (now called Cochrane GRADEing) was established to look at the applicability of review results to different groups of patients and how to best present the results of Cochrane Reviews so that they would be readily understood and widely used. The new group was convened by Paul Glasziou and Gordon Guyatt. In 2004, at the Cochrane Colloquium in Ottawa, Paul Glasziou and Andy Oxman led empirical work at an ARMG workshop exploring contents of a SoF table which would summarize the main beneficial and harmful effects in a tabular format. Holger Schünemann then replaced Paul Glasziou as co-convenor of the ARMG. Membership, scope of work and objectives of the Cochrane GRADEing (former ARMG) overlap with those of the GRADE Working Group. The GRADE Working Group began in the year 2000 as an informal collaboration of people with an interest in addressing the shortcomings of grading systems in health care.
Contact: for questions about the Cochrane GRADEing, please contact Holger Schünemann: email@example.com