One-Third of Systematic Reviews in Rehabilitation Applied the Grading of Recommendations Assessment,Development, and Evaluation (GRADE) System to Evaluate Certainty of Evidence: A Meta-Research Study |
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| Institution: | 1. IRCCS Istituto Ortopedico Galeazzi, Unit of Clinical Epidemiology, Milan, Italy;2. Unità Operativa di Neuropsichiatria Infanzia e Adolescenza (UONPIA), ASST Pavia, Italy;3. Vita-Salute San Raffaele University, Milan, Italy;4. Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael''s Hospital, Unity Health Toronto, Cochrane Hypertension Review Group, the Therapeutics Initiative, University of British Columbia, Canada;1. Department of Health Administration, Brooks College of Health, University of North Florida, Jacksonville, FL;2. Center for Data Solutions, Brooks Rehabilitation, Jacksonville, FL;3. Brooks Rehabilitation, Jacksonville, FL;1. School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand;2. Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen, Thailand;3. School of Integrative Medicine, Mae Fah Luang University, Chiang Rai, Thailand;4. Department of Rehabilitation Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand;1. Primary Care Centre Versus Arthritis, School of Medicine, Faculty of Medicine, Keele University, Newcastle-under-Lyme, UK;2. Nottingham University Hospitals NHS Trust, Queens Medical Centre, Derby Road, Nottingham, UK;3. Earl E Bakken Centre for Spirituality and Healing, University of Minnesota, Minneapolis, MN, USA;4. University of California San Diego, Herbert Wertheim School of Public Health and UCSD Health Services Research Centre, La Jolla, CA, USA;5. York Trials Unit, Department of Health Sciences, University of York, UK;6. Master''s and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil;7. Department of Psychology, University of Oslo, Oslo, Norway;1. Department of Epidemiology and Biostatistics, Michigan State University – College of Human Medicine, Grand Rapids, MI;2. John F. Butzer Center for Research and Innovation, Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI;3. Division of Rehabilitation, Michigan State University – College of Human Medicine, Grand Rapids, MI;4. Department of Biostatistics, Grand Valley State University, Grand Rapids, MI;1. Lyndhurst Centre, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada;2. KITE Research Institute, University Health Network, Toronto, Canada;3. Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, Canada;4. Institute of Medical Science, University of Toronto, Toronto, Canada;5. Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada;6. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada;7. Praxis Spinal Cord Institute, Vancouver, Canada;1. Exercise Biology, Department of Public Health, Aarhus University, Denmark;2. University of Lyon, UJM-Saint-Etienne, Inter-University Laboratory of Human Movement Biology, Saint-Etienne, France;3. The Danish MS Hospitals, Ry and Haslev, Denmark |
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| Abstract: | ObjectiveTo determine how many systematic reviews (SRs) of the literature in rehabilitation assess the certainty of evidence (CoE) and how many apply the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to do this.Data SourcesFor this meta-research study, we searched PubMed and Cochrane Database of Systematic Reviews databases for SRs on rehabilitation published in 2020.Study Selection and Data ExtractionTwo reviewers independently selected the SRs and extracted the data. Reporting characteristics and appropriate use of the GRADE system were assessed.Data SynthesisThe search retrieved 827 records: 29% (239/827) SRs evaluated CoE, 68% (163/239) of which applied the GRADE system. GRADE was used by SRs of randomized controlled trials (RCTs, 88%; 144/163), non-randomized intervention studies (NRIS, 2%; 3/163), and both RCT and NRIS (10%; 16/163). In the latter case, a separate GRADE assessment according to the study design was not provided in 75% (12/16). The reasons for GRADE judgment were reported in 82% (134/163) of SRs.ConclusionsOne-third of SRs in rehabilitation assessed CoE with the GRADE system. GRADE assessment was presented transparently by most SRs. Journal editors and funders should encourage the uptake of the GRADE system when considering SRs in rehabilitation for publication. The authors should pre-define GRADE assessment in a registered and/or published protocol. |
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