TY - CHAP M1 - Book, Section TI - Understanding and Applying the Results of a Systematic Review and Meta-analysis A1 - Murad, M. Hassan A1 - Montori, Victor M. A1 - Ioannidis, John P. A. A1 - Neumann, Ignacio A1 - Hatala, Rose A1 - Meade, Maureen O. A1 - Devereaux, PJ A1 - Wyer, Peter A1 - Guyatt, Gordon A2 - Guyatt, Gordon A2 - Rennie, Drummond A2 - Meade, Maureen O. A2 - Cook, Deborah J. Y1 - 2015 N1 - T2 - Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice, 3rd ed AB - In the previous chapter (Chapter 22, The Process of a Systematic Review and Meta-analysis), we provided guidance on how to evaluate the credibility of the process of a systematic review with or without a meta-analysis. In this chapter, we address how—if the systematic review is sufficiently credible—to decide on the degree of confidence in the estimates that the evidence warrants. As you will see, systematic review authors may have conducted a credible review and analysis and one may still have little confidence in the estimates of effect. We will return to the clinical scenario discussed in the previous chapter and obtain the relative and absolute effects of the intervention from a credible systematic review and meta-analysis1 and determine the confidence in these estimates (quality of evidence). The general framework for judging confidence in estimates is based on the approach offered by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) Working Group.2 This chapter focuses on questions of therapy or harm. This framework can, however, be adapted for other types of questions, such as issues of prognosis3 or diagnosis.4 SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/23 UR - jamaevidence.mhmedical.com/content.aspx?aid=1183877888 ER -