使用GRADEpro评价证据质量.ppt

I2 One set of criteria would say that an I2 of less than 40% is low 30～60% may be moderate 50～90% may be substantial 75～100% is considerable To rate inconsistency: If you think any inconsistency was negligible choose no If you think there was serious inconsistency choose serious ?this will downgrade the quality of evidence for this outcome by 1 level? If you think there was very serious inconsistency choose very serious ?this will downgrade the quality of evidence for this outcome by 2 levels? 间接证据（ Indirectness) There are two types of indirectness: 1. Indirect comparison 2. Indirect population intervention comparator outcome To rate indirectness: If you think the evidence is direct choose no If you have serious doubts about directness choose serious ?this will downgrade the evidence for this outcome by 1 level? If you have very serious doubts about directness choose very serious ?this will downgrade the evidence for this outcome by 2 levels? 精确度不够（Imprecision ） 当研究纳入的患者和观察事件相对较少而致可信区间较宽时，指南小组将降低该研究的证据质量。 A threshold rule-of-thumb value Total number of events is less than 300（dichotomous） Total population size is less than 400（continuous） To rate imprecision: If you think the results were precise choose no If there was serious imprecision choose serious ?this will downgrade the quality of evidence for this outcome by 1 level? If there was very serious imprecision choose very serious ?this will downgrade the quality of evidence for this outcome by 2 levels? 发表偏倚（ Publication bias ） Publication bias arises when investigators fail to report studies they have undertaken (typically those that show no effect). Methods to detect the possibility of publication bias in systematic reviews exist, although authors of the reviews and guideline panels must often guess about the likelihood of publication bias. A prototypical situation that should elicit suspicion of publication bias occurs when published evidence is limited to a small number of trials, all