Intended for healthcare professionals

Research Methods & Reporting

GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 2: Clinical practice guidelines

BMJ 2016; 353 doi: https://doi.org/10.1136/bmj.i2089 (Published 30 June 2016) Cite this as: BMJ 2016;353:i2089

Re: GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 2: Clinical practice guidelines

Thank you Professor Treweek. It is encouraging to note that I am not too off base here. Looking back, I believe the reasons for my original comment regarding the plain language summary were the following:

The view that the point estimate is our best estimate of the population parameter is, I suspect, contentious (for example, see section 4.2.4 of Spanos A. Philosophy of Econometrics. 2007)

While the Cochrane Handbook for Systematic Reviews of Interventions (online version 5.1.0), I acknowledge, does state that “The point estimate (0.75) is the best guess of the magnitude and direction….”, it also states that “If the confidence interval was wider still, and included the null value of a difference of 0%, we will not have excluded the possibility that the treatment has any effect whatsoever, and would need to be even more sceptical in our conclusion”

Thank you once again for your thoughtful replies.

Competing interests: No competing interests

30 August 2016
Mohammed T. Ansari
Adjunct Professor
University of Ottawa
Ottawa, ON, Canada