Recommendations for rating the certainty of evidence for rapid reviews (RRs)
| General recommendations to increase efficiency | Focus on interventions, comparators and outcomes most relevant to knowledge users and people who live with the condition. Outcomes should include benefits and harms. |
| Use GRADEpro to increase efficiency and consistency when rating COE. | |
| Recommendations to maintain consistency with GRADE | Do not modify the definition of COE or the domains that determine the COE for an outcome when using GRADE |
| Use evidence profiles and summary of findings tables with explanatory footnotes that provide reasons for uprating and downrating to present the COE of outcomes. | |
| Recommendations to accelerate GRADE application | GRADE recommends a literature review or a Delphi-like approach involving knowledge users and people with the condition to rate the importance of outcomes that are most important for decision making. If a literature review or a formal Delphi approach are not feasible, use informal judgements of knowledge users, topic experts (including people who live with the condition), or internal team members to prioritise the outcomes to be graded. |
| GRADE recommends rating the COE of the seven most important outcomes representing benefits and harms. To accelerate the process, consider rating fewer than seven outcomes. | |
| GRADE guidance recommends that two reviewers independently rate the COE and then agree on a final rating. To accelerate the process, consider using a single reviewer to rate the certainty of evidence, and verify all decisions (and footnoted rationales) by a second reviewer. | |
| Recommendations when using an existing systematic review or network meta-analysis | If effect estimates of a well-conducted systematic review, meta-analysis, or network meta-analysis are incorporated to address parts of a key question of the RR, we advise using existing COE grades from such reviews. |
| For network meta-analyses, GRADE recommends rating the COE for direct and indirect estimates separately. To accelerate the process, rate only the COE of the direct estimate. If there is incoherence with the indirect estimate, further downgrade. | |
| If a network meta-analysis presents only indirect estimates, rate the COE and then further downgrade for indirectness. |
COE, certainty of evidence; GRADE, Grading of Recommendations Assessment, Development and Evaluation.