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Title of Journal: International Orthopaedics SICOT

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Abbravation: International Orthopaedics

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Springer-Verlag

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10.1002/fut.3990050411

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1432-5195

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GRADE outcomes or studies how to use the GRADE ap

Authors: Zhi Mao Lihai Zhang Yaolong Chen Peifu Tang
Publish Date: 2013/01/11
Volume: 37, Issue: 3, Pages: 553-553
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Abstract

We read with deep interest the article by Houwert et al 1 We appreciate the work of the authors on the systematic review related to the two major therapeutic choices for displaced midshaft clavicle fractures However we have some comments about the using of GRADE approachFirst the GRADE approach defines the quality of a body of evidence for outcomes reported in systematic reviews 2 3 The level of quality of evidence should be rate separately for each outcome In Houwert’s research the authors used the GRADE approach as an evaluation tool for the studies with similar risk of a bias toolThird high quality means “We are very confident that the true effect lies close to that of the estimate of the effect” 3 in the GRADE system However the authors drew conclusions of “high quality evidence” from only one included study without any additional analysisTo summarise the GRADE approach should be used for grading the quality of evidence for outcomes but not included studies based on a systematic review Nonetheless the above points cannot lessen the overall value of this work and we thoroughly enjoyed reading the article with that in mind

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