A for Effort: Learning From the Application of the GRADE Approach to Cancer Guideline Development

Abstract

Few would argue against a methodology that facilitates more explicit and transparent judgments about health care research evidence and the link to practice and policy decisions. In this issue of the JournalofClinicalOncology,DePalmaetal 1 describetheapplicationof one such method, the GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) approach, for the development of clinical practice guidelines for breast, colorectal, and lung cancer treatment. The GRADE approach has emerged in response to concerns about the glut of competing grading systems, their limitations, and the confusion resulting from lack of a common rubric. GRADE (http://www.gradeworkinggroup.org/) provides an explicit method for arriving at recommendations classified according to the quality of supporting evidence. 2-8