Evidence map›Paper›PMID 34800676›Full record

ArticleJournal of clinical epidemiology2022

GRADE guidance 24 optimizing the integration of randomized and non-randomized studies of interventions in evidence syntheses and health guidelines.

Carlos A Cuello-Garcia, Nancy Santesso, Rebecca L Morgan, Jos Verbeek, Kris Thayer, Mohammed T Ansari, Joerg Meerpohl, Lukas Schwingshackl, Srinivasa Vittal Katikireddi, Jan L Brozek and 10 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of clinical epidemiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 77 papers, 35 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
77citing papers in PubMed, 35 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

77 citing papers in PubMed, 35 syntheses or guidelines pooled it.

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  9. Human papillomavirus (HPV) vaccination in women with conisation.The Cochrane database of systematic reviews · 2025
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  13. The use of telemedicine services for medical abortion.The Cochrane database of systematic reviews · 2025
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17 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Carlos A Cuello-GarciaDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Department of Health Quality Improvement. Tecnologico de Monterrey School of Medicine, Monterrey, Nuevo Leon, Mexico. Electronic address: cuelloca@mcmaster.ca.
Nancy SantessoDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Rebecca L MorganDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Jos VerbeekCochrane Work Review Group. Occupational Medicine. Finnish Institute of Occupational Health, Helsinki, Uusimaa, Finland.
Kris ThayerIntegrated Risk Information System (IRIS) Division, National Center for Environmental Assessment, Environmental Protection Agency, Washington, D.C., USA.
Mohammed T AnsariSchool of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, QC, Canada.
Joerg MeerpohlInstitute for Evidence in Medicine, Medical Center & Faculty of Medicine, University of Freiburg, Freiburg, Baden-Wurttemberg, Germany; Cochrane Germany, Cochrane Germany Foundation, Freiburg, Baden-Wurttemberg, Germany.
Lukas SchwingshacklInstitute for Evidence in Medicine, Medical Center & Faculty of Medicine, University of Freiburg, Freiburg, Baden-Wurttemberg, Germany.
Srinivasa Vittal KatikireddiMRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Greater Glasgow, Scotland.
Jan L BrozekDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, McMaster University. Hamilton, Ontario, Canada.
Barnaby ReevesSchool of Clinical Sciences, University of Bristol, Bristol, South West, England.
Mohammad H MuradEvidence-Based Practice Center, Mayo Clinic, Rochester, Minnesota, USA.
Maicon FalavignaFederal University of Rio Grande do Sul, Institute for Health Technology Assessment, Porto Alegre, Rio Grande do Sul, Brazil.
Reem MustafaDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Division of Nephrology and Hypertension, Department of Medicine, University of Kansas Medical Center, Kansas City, Missouri USA.
Deborah L RegidorEvidence Services, Kaiser Permanente, Care Management Institute, Oakland, California, USA.
Paul Elias AlexanderDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Paul GarnerDepartment of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, Merseyside, England.
Elie A AklDepartment of Internal Medicine, American University of Beirut, Beirut Governorate, Lebanon.
Gordon GuyattDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, McMaster University. Hamilton, Ontario, Canada.
Holger J SchünemannDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, McMaster University. Hamilton, Ontario, Canada. Electronic address: schuneh@mcmaster.ca.

Funding

Chief Scientist Office SCAF/15/02Chief Scientist Office SPHSU13Chief Scientist Office SPHSU15Chief Scientist Office SPHSU17Medical Research Council MC_UU_00022/2Medical Research Council MC_UU_12017/13Medical Research Council MC_UU_12017/15
6 · The paper itself

Abstract

BACKGROUND AND

objectiveThis is the 24th in the ongoing series of articles describing the GRADE approach for assessing the certainty of a body of evidence in systematic reviews and health technology assessments and how to move from evidence to recommendations in guidelines.

methodsGuideline developers and authors of systematic reviews and other evidence syntheses use randomized controlled studies (RCTs) and non-randomized studies of interventions (NRSI) as sources of evidence for questions about health interventions. RCTs with low risk of bias are the most trustworthy source of evidence for estimating relative effects of interventions because of protection against confounding and other biases. However, in several instances, NRSI can still provide valuable information as complementary, sequential, or replacement evidence for RCTs.

resultsIn this article we offer guidance on the decision regarding when to search for and include either or both types of studies in systematic reviews to inform health recommendations.

conclusionThis work aims to help methodologists in review teams, technology assessors, guideline panelists, and anyone conducting evidence syntheses using GRADE.

Indexed as

Research DesignTechnology Assessment, BiomedicalBiasHumansSystematic Reviews as TopicCertainty of evidenceGRADENon-randomized studiesQuality of evidenceRisk of biasROBINS

Identifiers

PMID34800676
PMCPMC8982640

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.