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Harmonization of explanations for common judgments about the quality of evidence in Summary of Findings Tables

Date and Location




Monday 23 September 2013 - 13:30 - 15:00
Presenting author and contact person

Presenting author

Miranda Langendam

Contact person

Miranda Langendam
Holger Schunemann
Abstract text
Background: Assessing the quality of the body of evidence (QoE) using the GRADE criteria, justifying and documenting these assessments are desirable for new Cochrane Reviews as part of Summary of Findings (SoF) tables (MECIR standards). In an evaluation of SoF tables, we observed variability in how authors of Cochrane reviews report their assessments in footnotes and comments. Harmonization of explanations for common judgments is one of the aims of this Methods Innovation Fund project. Objectives: To provide templates of standardized wording of footnotes and comments in SoF tables in order to enhance their usefulness and facilitate interpretation. Methods: Standardized footnotes and related guidance are currently being developed based on a database of footnotes and comments from SoF tables published in the Cochrane Library Issue 3, 2012 (n=502). The footnotes and comments will be aggregated by pre-defined and newly discovered themes. Preliminary pre-defined themes are justification for judgments about each of the GRADE QoE domains (reasons for downgrading and not downgrading as well as upgrading the evidence), judgments across domains, explanations in the face of single RCTs, no meta-analysis and refraining from grading the evidence. The method for evaluating the usefulness of footnotes is in development but will include assessments by experienced GRADE users as well as by a representative sample of users of SoF tables. Selected anonymized examples will be included in training materials and GRADEpro software. Results: Preliminary results indicate that Cochrane authors used different styles in reporting footnotes and sometimes provide reasons for their judgments that contradict current guidance (e.g. for single study evidence and upgrading of RCTs). Final results will be presented at the Colloquium. Conclusions: Knowing how authors approach footnotes is a useful indicator of possible areas where more training or guidance is needed, e.g. in the Cochrane and GRADE Handbook and GRADEpro software.