A snapshot of the Advanced GRADE Methodology Workshop, McMaster University, Canada

Advanced GRADE Methodology Workshop

The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) is a framework for developing and presenting summaries of evidence used in health research and provides a systematic and transparent approach for making clinical practice recommendations. This framework is used by over 100 research institutions worldwide, including by the Cochrane Infectious Diseases Group in their Cochrane systematic reviews. 

GRADE guidance is frequently updated with ongoing improvements in health research methodologies. In May 2024, Clinical Research Associate Dr Rebecca Kuehn from the Cochrane Infectious Diseases Group (CIDG) attended a 3 day workshop in Advanced GRADE Methodology at McMaster University, Canada, to learn the updated guidance concerning issues regarding the target of the rating of certainty of evidence. This was a fantastic opportunity to learn from world experts in this field, including Professor Gordon Guyatt, a pioneer of the development of GRADE methods. Attendees came from all over the world to discuss the latest updates in an inclusive, collaborative, and stimulating environment. 

Day 1 began with a review of GRADE fundamentals, bringing everyone up to speed and on the same page regarding the key components and applications of GRADE. Following this, sessions launched into explaining the guidance concerning targets for certainty ratings, with a wide range of examples and engaging discussions.

Day 2 included teaching on the plain language certainty of evidence, and sessions on the need for values and preference judgements. This day included breakout sessions with thought-provoking exercises using a study that vividly demonstrated the need for value judgements in targets for certainty ratings, with high-energy discussions from all participants. 

Day 3 involved further highly relevant examples from recent systematic reviews, discussed in small groups, to further explore and solidify the concepts learn over the last two days. The afternoon sessions were a chance to discuss any issues experienced in GRADE methods, and a lively discussion about surrogate outcomes and aspects of GRADE in network meta-analysis methods ensued. 

All sessions were smoothly and professionally facilitated by the team at McMaster. Questions were encouraged and thoughtfully considered, and relevant and interesting practical examples to work through during small breakout group sessions. The workshop was also a brilliant chance to meet others using GRADE within their varied research interests all over the globe, and to discuss the application of it in their work. A high sense of energy and enthusiasm for using the guidance was imparted to participants for their upcoming reviews!

Readers interested in the new guidance may find these papers useful: 
1.    https://www.jclinepi.com/article/S0895-4356(21)00108-6/fulltext 
2.    https://www.sciencedirect.com/science/article/pii/S089543561630703X 


Rebecca Kuehn is supported by the Research, Evidence and Development Initiative (READ-It) project. READ-It (project number 300342-104) is funded by UK aid from the UK government; however, the views expressed do not necessarily reflect the UK government’s official policies.