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[GRADE Guidelines: 7. Rating The Quality Of Evidence - Inconsistency].

M. Perleth, G. Langer, J. Meerpohl, G. Gartlehner, Angela Kaminski-Hartenthaler, H. Schünemann
Published 2012 · Medicine, Psychology

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This article deals with inconsistency of relative, rather than absolute, treatment effects in binary/dichotomous outcomes. A body of evidence is not rated up in quality if studies yield consistent results, but may be rated down in quality if inconsistent. Criteria for evaluating consistency include similarity of point estimates, extent of overlap of confidence intervals, and statistical criteria including tests of heterogeneity and I(2). To explore heterogeneity, systematic review authors should generate and test a small number of a priori hypotheses related to patients, interventions, outcomes, and methodology. When inconsistency is large and unexplained, rating down quality for inconsistency is appropriate, particularly if some studies suggest substantial benefit, and others no effect or harm (rather than only large versus small effects). Apparent subgroup effects may be spurious. Credibility is increased if subgroup effects are based on a small number of a priori hypotheses with a specified direction; subgroup comparisons come from within rather than between studies; tests of interaction generate low p-values; and have a biological rationale.



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G. Vesentini (2020)
10.1136/bjsports-2017-098032
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D. Steffens (2018)
10.1016/J.ARBRES.2012.12.001
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P. Alonso-Coello (2013)
10.1155/2018/6387810
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L. Du (2018)
10.1007/s13300-018-0482-5
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Dan Qian (2018)
10.1155/2014/785039
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Perani Daniela (2014)
10.1002/ijc.30185
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S. Manthravadi (2016)
10.1136/bmjopen-2016-011218
Identification of adults with sepsis in the prehospital environment: a systematic review
M. Smyth (2016)
10.1007/s00103-019-02898-x
Die neue Standardvorgehensweise der Ständigen Impfkommission (STIKO): Entstehung, Struktur und Umsetzung
T. Harder (2019)
10.1016/j.jclinepi.2015.08.027
Sensitivity subgroup analysis based on single-center vs. multi-center trial status when interpreting meta-analyses pooled estimates: the logical way forward.
Paul E. Alexander (2016)
10.23970/ahrqepcmethguide2
Assessing the Risk of Bias of Individual Studies in Systematic Reviews of Health Care Interventions
M. Viswanathan (2012)
10.13188/2373-1133.1000012
Efficacy of Atypical Antipsychotics to Treat Behavioral and Psychological Symptoms of Dementia in Nursing Home Residents: A Systematic Review of the Evidence from Randomized Controlled Trials
Taylor Haight (2015)
10.1093/bja/aet166
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G. Imberger (2013)
10.1186/s12879-017-2342-8
Effectiveness of Progressive Resistive Exercise (PRE) in the context of HIV: systematic review and meta-analysis using the Cochrane Collaboration protocol
K. O'Brien (2017)
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J. Criniti (2014)
Intracoronary versus intravenous administration of abciximab during percutaneous coronary intervention for acute coronary syndrome : grading the evidence through a meta-analysis of randomized controlled trials
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10.4103/eus.eus_63_18
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10.1089/neu.2015.4192
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10.1097/EDE.0000000000000354
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C. Poole (2015)
10.1101/2020.04.13.20064352
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10.1136/bjsports-2019-101375
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J. Dias (2020)
10.1186/s13643-019-1110-9
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Rejina Gurung (2019)
10.1136/bmjopen-2015-009998
Effect of serotonin modulating pharmacotherapies on body mass index and dysglycaemia among children and adolescents: a systematic review and network meta-analysis protocol
Reem A Al Khalifah (2016)
10.1016/j.arbres.2012.12.001
Quality and strength: the GRADE system for formulating recommendations in clinical practice guidelines.
P. Alonso-Coello (2013)
10.1016/j.jclinepi.2017.01.014
GRADE equity guidelines 1: considering health equity in GRADE guideline development: introduction and rationale
V. Welch (2017)
10.1007/s10147-015-0801-z
Japanese Society for Cancer of the Colon and Rectum (JSCCR) Guidelines 2014 for treatment of colorectal cancer
T. Watanabe (2015)
10.1212/WNL.0000000000000815
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