Systematic assessments of health technologies based on the best available evidence have become a cornerstone to many health care systems in deciding of whether to include a technology, a health care service, or pharmaceuticals in the public health care coverage system. Although most organisations use some principles of evidence-based medicine for their evaluations, they are confronted with shortcomings of their current methodology in rating the quality of evidence and with discrepancies in the results that might result from applying different rating systems to the same body of evidence. Frequently, however, the evaluations lack transparency to fully understand differences in the conclusions across organisations.

An international group of methodologists, clinical reseachers, reviewers and guideline developers from acknowledged organisations worldwide – the GRADE* Working Group - put together their experience and methodological knowhow to develop a rating system that addresses the recognised de ficiencies. This system then moves on in formulating recommendations that explicitly map the path from the evidence to the recommendation including the underlying value considerations to finally reach recommendations on whether (or not) to apply a technology that are graded in two tiers, strong or weak. The comprehensive considerations integrated in the system, the explicit and transparent approach in rating the methodological quality and grading the recommendations contribute to the fast uptake of the grading system in the scientific community involved in systematic reviews, technology assessments and guideline developments.

This session introduces the GRADE system to the Cochrane community. The first presentation describes the advancement of the GRADE methodology in rating the methodological quality compared to previous rating systems. 

* Grade of Recommendation Assessments, Development and Evaluation (GRADE)
www.gradeworkinggroup.org