Date Published: September 15, 2009
Publisher: Public Library of Science
Author(s): Brian P. Kavanagh
Abstract: Brian Kavanagh critiques the GRADE system of grading guidelines, arguing that even though it has evolved through the Evidence-Based Medicine movement, there is no evidence that GRADE itself is reliable.
Partial Text: Professional medical groups commonly issue clinical practice guidelines. Such guidelines are traditionally the result of consensus conferences or expert panels and represent attempts to synthesize—from the best available evidence and expertise—practical guidance on the best possible care. Beyond issuing a guideline, many organizations have felt the need to provide a grading of each guideline’s quality, thereby conveying to the reader a sense of the confidence that might be placed in it. This article addresses only the grading of guidelines, not their use or development.