ORCID
- Prashanti Eachempati: 0000-0003-1263-7423
Abstract
This fourth article in a seven part series presents the Core GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to addressing risk of bias, publication bias, and rating up certainty. In Core GRADE, randomised controlled trials begin as high certainty evidence and non-randomised studies of interventions (NRSI) as low certainty. To assess certainty of evidence for risk of bias, Core GRADE users first classify individual studies as low or high risk of bias. Decisions regarding rating down for risk of bias will depend on the weights of high and low risk of bias studies and similarities or differences between the results of high and low risk of bias studies. For publication bias, a body of evidence comprising small studies funded by industry should raise suspicion. Core GRADE users appraising results from well conducted NSRI can consider rating up certainty of evidence when risk ratios from pooled estimates suggest large or very large effects.
DOI Link
Publication Date
2025-05-13
Publication Title
The BMJ
Volume
389
ISSN
0959-8146
Acceptance Date
2025-03-21
Deposit Date
2025-05-21
Additional Links
Recommended Citation
Guyatt, G., Wang, Y., Eachempati, P., Iorio, A., Murad, M., Hultcrantz, M., Chu, D., Florez, I., Hemkens, L., Agoritsas, T., Yao, L., Vandvik, P., Montori, V., & Brignardello-Petersen, R. (2025) 'Core GRADE 4: rating certainty of evidence—risk of bias, publication bias, and reasons for rating up certainty', The BMJ, 389. Available at: 10.1136/bmj-2024-083864
