Assessing the certainty of the evidence from network-meta analysis using the GRADE approach

Workshop category: 

  • Other review formats (e.g. overviews of reviews, network meta-analysis)
Date and Location


Wednesday 23 October 2019 - 16:00 to 17:30


Contact persons and facilitators

Contact person:


Brignardello-Petersen R1, Sadeghirad B2, Guyatt G3
1 McMaster University, Canada
2 Department of Health Research Methods, Evidence, and Impact, McMaster University, Canada
3 , Canada
Target audience

Target audience: 

Review authors

Level of difficulty: 

Type of workshop

Type of workshop : 



Background: assessing the certainty of evidence is among the Methodological Expectations of Cochrane Intervention Reviews (MECIR) standards, and it is also acknowledged as a key step in non-Cochrane reviews. Appropriate interpretation of the results from network meta-analysis (NMA) requires considering the certainty of the evidence. However, the assessment of the certainty of the evidence has not been widely implemented in systematic reviews that include NMA.

Objectives: for individuals considering conducting a NMA, to gain familiarity with and begin to gain facility in applying the GRADE Working Group approach to rating certainty of evidence in paired comparisons within a NMA.

Description: the GRADE Working Group has developed an approach to rating certainty of evidence (also known as confidence in evidence or quality of evidence) in each paired comparison within a network meta-analysis. The approach involves three steps: 1) rate the certainty of the direct estimates, 2) rate the certainty of the indirect estimates, 3) rate the certainty of the network estimates.

The workshop will begin with an interactive lecture providing details of the approach and then review a step-by-step template for applying the approach. Workshop participants will then break into groups of five or six to work through an example of a NMA, guided by facilitators when needed. Before the end of the session, the facilitators will lead the large group in a discussion of the results and details of the assessments.