Please use this identifier to cite or link to this item:
http://hdl.handle.net/11375/32259Full metadata record
| DC Field | Value | Language |
|---|---|---|
| dc.contributor.advisor | Guyatt, Gordon | - |
| dc.contributor.author | Movahed, Hamed | - |
| dc.date.accessioned | 2025-08-28T15:35:58Z | - |
| dc.date.available | 2025-08-28T15:35:58Z | - |
| dc.date.issued | 2025 | - |
| dc.identifier.uri | http://hdl.handle.net/11375/32259 | - |
| dc.description.abstract | Background: Systematic review authors using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach must establish thresholds to assess certainty of evidence. Objectives: To describe how systematic review authors applied thresholds and thus inform the perceived usefulness of the available thresholds for authors using GRADE. Methods: We conducted a systematic survey sampling the 200 most recently published Cochrane and 200 non-Cochrane reviews that used GRADE. We documented how review authors used thresholds and the thresholds they chose (the null, minimally important difference [MID], or MID, moderate and large effect thresholds). Results: Among the sampled reviews, 118 of 200 (59%) Cochrane and 63 of 200 (31.5%) non-Cochrane reviews used thresholds. Of these, we identified the threshold type in 112 of 118 (94.9%) and 55 of 63 (87.3%), in turn. Among these, 55 of 112 (49.1%) Cochrane and 26 of 55 (47.3%) non-Cochrane reviews used the null, while 54 of 112 (48.2%) and 25 of 55 (45.5%), respectively, used the MID. Few used the MID, moderate, and large effects thresholds (2 of 112 [1.8%] Cochrane; 3 of 55 [5.5%] non-Cochrane) or applied the null for some outcomes and the MID for others (1 of 112 [0.9%] Cochrane; 2 of 55 [3.6%] non-Cochrane). Among reviews with identifiable thresholds, 15 of 112 (13.4%) Cochrane and 17 of 55 (30.9%) non-Cochrane reviews mentioned or referred to the thresholds in their methods sections. Conclusions: Reporting and application of thresholds in systematic reviews remain limited. Over 40% of Cochrane and more than two-thirds of non-Cochrane reviews showed no apparent threshold use, reflecting either a lack of transparency in reporting or, more likely, the absence of threshold usage. When thresholds were identifiable, the null and MID were most commonly and equally used, suggesting that review authors consider both valuable for rating certainty of evidence. | en_US |
| dc.language.iso | en | en_US |
| dc.subject | Grading of Recommendations Assessment, Development and Evaluation (GRADE); certainty of evidence; thresholds for certainty rating; minimally important difference (MID); null threshold; systematic review | en_US |
| dc.title | Application of Thresholds for Rating Certainty of Evidence Using the GRADE Approach: A Systematic Survey of Systematic Reviews | en_US |
| dc.title.alternative | APPLICATION OF THRESHOLDS FOR CERTAINTY RATING USING GRADE | en_US |
| dc.type | Thesis | en_US |
| dc.contributor.department | Health Research Methodology | en_US |
| dc.description.degreetype | Thesis | en_US |
| dc.description.degree | Master of Science (MSc) | en_US |
| dc.description.layabstract | Systematic reviews of interventions provide evidence to support health decisions by summarizing findings from available studies. Review authors assess their confidence in the evidence using a system called GRADE (Grading of Recommendations Assessment, Development, and Evaluation). A key part of GRADE is setting thresholds—cut-off points. A common threshold is the null, which checks whether or not there is any effect at all. Another is the minimally important difference (MID), which considers whether the effect is important to patients. We analyzed 400 systematic reviews to examine how these thresholds were applied. Over half of the reviews did not clearly use or report thresholds. Among those that did, more or less equal number used the null threshold and the MID. Our findings establish that review authors need to apply and report thresholds, as instructed by GRADE. Those who apply thresholds find the null and the MID equally useful thresholds when rating GRADE certainty. | en_US |
| Appears in Collections: | Open Access Dissertations and Theses | |
Files in This Item:
| File | Description | Size | Format | |
|---|---|---|---|---|
| Movahed_Hamed_2025August_MSc.pdf | 965.73 kB | Adobe PDF | View/Open |
Items in MacSphere are protected by copyright, with all rights reserved, unless otherwise indicated.
