EU Science Hub

GRADE Workshop on the Development of Evidence-Based Guidelines

Dec 11 2013
Dec 12 2013

The JRC organised a workshop on development of evidence-based guidelines focusing on GRADE, which is a method for grading the quality of evidence and the strength of recommendations in healthcare. The aim was to create a common knowledge platform for JRC and other EC colleagues. The workshop was also intended as a template for possible future trainings dedicated to external stakeholders.


The European Commission (EC) within its EC Initiative on Breast Cancer (ECIBC) will be directly involved in the development of guidelines on breast cancer screening and diagnosis. These guidelines were required by the Council to be evidence-based. This means, among other things, that they have to be based on the systematic review of the research and on explicit and transparent processes to minimize biases and conflicts of interest.

The workshop, organised by the Public Health Policy Support Unit of the IHCP, was supported by the GRADE Working Group and Cochrane Training. The participants rated the workshop very positively and expressed the need to organise additional events focusing on guidelines implementation and on the use of GRADE in public health.

More details regarding the workshop will be available in a forthcoming report and can be obtained through the above e-mail contact.

Background information
GRADE stands for "Grading of Recommendations Assessment, Development and Evaluation". This method aims to be explicit, comprehensive, transparent, and pragmatic. Many organisations around the world, such as WHO, NICE, or The Cochrane Collaboration, use or support GRADE.

The EC supported the development of GRADE software (GRADEpro) and other tools which will be applied in the ECIBC, like those suggested by the DECIDE project.


All presentations are available in PDF format


Guideline development process and the GRADE approach

Types of questions. Framing a question: PICO format

Choosing outcomes. Relative importance of outcomes

PICO exercise

Study designs

Study designs exercise

Literature searches

Literature search exercise

Determinants of quality of evidence: What can lower the quality? (I) Risk of bias. Indirectness

Risk of bias exercise

Determinants of quality of evidence: What can lower the quality? (II)

What can upgrade the evidence?

Going from evidence to recommendations

Economic evidence

Using the Guideline Development Tool (GDT) software exercise

GRADE bibliography