Skip to Main Content

Systematic Reviews

Resources for planning and conducting a Systematic Review of the literature.

Evidence Synthesis: GRADE (Grades of Recommendation, Assessment, Development and Evaluation) for Quantitative Studies

GRADE is a valuable framework assisting systematic review authors in assessing the certainty of the evidence. Five specific domains (Risk of Bias, Publication Bias, Imprecision, Inconsistency, Indirectness)  are incorporated in the GRADE approach. Select article titles provided and accompanied by video links for summary of findings table implementation related to each domain: 

Additional GRADE Resources:

Examples of the GRADE Approach

  • Gonçalves-Bradley  DC, J Maria  AR, Ricci-Cabello  I, Villanueva  G, Fønhus  MS, Glenton  C, Lewin  S, Henschke  N, Buckley  BS, Mehl  GL, Tamrat  T, Shepperd  S. Mobile technologies to support healthcare provider to healthcare provider communication and management of care. Cochrane Database of Systematic Reviews 2020, Issue 8. Art. No.: CD012927. DOI: 10.1002/14651858.CD012927.pub2.Summary of Findings tables 1-3 displays Certainty of the Evidence (GRADE) judgements

  • Martin-Gomez C, Sestelo-Diaz R, Carrillo-Sanjuan V, Navarro-Santana MJ, Bardon-Romero J, Plaza-Manzano G. Motor control using cranio-cervical flexion exercises versus other treatments for non-specific chronic neck pain: A systematic review and meta-analysis. Musculoskeletal Science and Practice. 2019;42:52-59. Table 4: GRADE Assessment, displays Quality of the Evidence based on the five domains

Evidence Synthesis: GRADE-CERQual for Qualitative Studies

Assessment is based upon four components: Methodological Limitations, Coherence, Adequacy of Data, Relevance of Data. Links to their individual articles are included and accompanied by its associated "assessing" video pertaining to that component.

  • Methodological Limitations: Munthe-Kaas H, Bohren MA, Glenton C, Lewin S, Noyes J, Tunçalp Ö, Booth A, Garside R, Colvin CJ, Wainwright M, Rashidian A, Flottorp S, Carlsen B. Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 3: how to assess methodological limitations. Implementation Science. 2018 Jan 25;13(Suppl 1):9. Assessing the methodological limitations component of GRADE-CERQual.
  • Coherence: Colvin CJ, Garside R, Wainwright M, Munthe-Kaas H, Glenton C, Bohren MA, Carlsen B, Tunçalp Ö, Noyes J, Booth A, Rashidian A, Flottorp S, Lewin S. Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 4: how to assess coherence. Implementation Science. 2018 Jan 25;13(Suppl 1):13. Assessing the coherence component of GRADE-CERQual.
  • Adequacy of Data: Glenton C, Carlsen B, Lewin S, Munthe-Kaas H, Colvin CJ, Tunçalp Ö, Bohren MA, Noyes J, Booth A, Garside R, Rashidian A, Flottorp S, Wainwright M. Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 5: how to assess adequacy of data. Implementation Science. 2018 Jan 25;13(Suppl 1):14. Assessing the adequacy component of GRADE-CERQual.
  • Relevance of Data: Noyes J, Booth A, Lewin S, Carlsen B, Glenton C, Colvin CJ, Garside R, Bohren MA, Rashidian A, Wainwright M, Tunςalp Ö, Chandler J, Flottorp S, Pantoja T, Tucker JD, Munthe-Kaas H. Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 6: how to assess relevance of the data. Implementation Science. 2018 Jan 25;13(Suppl 1):4. Assessing the relevance component of GRADE-CERQual.

Additional GRADE-CERQual Resources:

Booth A, Lewin S, Glenton C, Munthe-Kaas H, Toews I, Noyes J, Rashidian A, Berg RC, Nyakang'o B, Meerpohl JJ; GRADE-CERQual Coordinating Team. Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 7: understanding the potential impacts of dissemination bias. Implementation Science. 2018 Jan 25;13(Suppl 1):12.

Lewin S, Bohren M, Rashidian A, Munthe-Kaas H, Glenton C, Colvin CJ, Garside R, Noyes J, Booth A, Tunçalp Ö, Wainwright M, Flottorp S, Tucker JD, Carlsen B. Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 2: how to make an overall CERQual assessment of confidence and create a Summary of Qualitative Findings table. Implementation Science. 2018 Jan 25;13(Suppl 1):10.