GRADE guidelines 32: GRADE offers guidance on choosing targets of GRADE certainty of evidence ratings.
OBJECTIVE
To provide practical principles and examples to help GRADE users make optimal choices regarding their ratings of certainty of evidence using a minimally or partially contextualized approach.


STUDY DESIGN AND SETTING
Based on the GRADE clarification of certainty of evidence in 2017, a project group within the GRADE Working Group conducted iterative discussions and presentations at GRADE Working Group meetings to refine this construct and produce practical guidance.


RESULTS
Systematic review and health technology assessment authors need to clarify what it is in which they are rating their certainty of evidence (i.e., the target of their certainty rating). The decision depends on the degree of contextualization (partially or minimally contextualized), thresholds (null, small, moderate or large effect threshold), and where the point estimate lies in relation to the chosen threshold(s). When the 95% confidence interval crosses multiple possible thresholds (i.e., including both large benefit and large harm), it is not worthwhile for authors to determine the target of certainty rating.


CONCLUSION
GRADE provides practical principles to help systematic review and health technology assessment authors specify the target of their certainty of evidence rating.
['Zeng|Linan|L|', 'Brignardello-Petersen|Romina|R|', 'Hultcrantz|Monica|M|', 'Siemieniuk|Reed A C|RAC|', 'Santesso|Nancy|N|', 'Traversy|Gregory|G|', 'Izcovich|Ariel|A|', 'Sadeghirad|Behnam|B|', 'Alexander|Paul E|PE|', 'Devji|Tahira|T|', 'Rochwerg|Bram|B|', 'Murad|Mohammad H|MH|', 'Morgan|Rebecca|R|', 'Christensen|Robin|R|', 'Schünemann|Holger J|HJ|', 'Guyatt|Gordon H|GH|']
D000077002:GRADE Approach D006801:Humans D017410:Practice Guidelines as Topic D000078202:Systematic Reviews as Topic
GRADE Systematic review Health technology assessment Thresholds Evidence-based medicine Target of certainty of evidence rating