Anesthesia for Operative Caesarean Section Delivery
- Evidence Assessment
According to WHO Handbook for Guidelines, we used the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach to assess the quality of a body of evidence, develop and report recommendations. GRADE methods are used by WHO because these represent internationally agreed standards for making transparent recommendations.
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Detailed GRADE information is available on the following sites:
- GRADE working group:https://www.gradeworkinggroup.org/
- GRADE online training modules: http://cebgrade.mcmaster.ca/
Quality Definition Implications
Evidence is categorized as High, Moderate, Low and Very low.
Table 1: Quality and Significance of the Four Levels of Evidence in GRADE:
|
Quality
|
Definition |
Implications |
|
High |
The guideline development group is very confident that the true effect lies close to that of the estimate of the effect.
|
Further research is very unlikely to change confidence in the estimate of effect
|
|
Moderate |
The guideline development group is moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.
|
Further research is likely to have an important impact on confidence in the estimate of effect and may change the estimate
|
|
Low |
Confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the true effect. |
Further research is very likely to have an important impact on confidence in the estimate of effect and is unlikely to change the estimate
|
|
Very low |
The group has very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of the effect.
|
Any estimate of effect is very uncertain
|