GRADE outcomes or studies: how to use the GRADE approach correctly?

摘要

We read with deep interest the article by Houwert et al. [1]. We appreciate the work of the authors on the systematic review related to the two major therapeutic choices for displaced mid-shaft clavicle fractures. However, we have some comments about the using of GRADE approach. First, the GRADE approach defines the quality of a body of evidence for outcomes reported in systematic reviews [2, 3]. The level of quality of evidence should be rate separately for each outcome. In Houwert's research, the authors used the GRADE approach as an evaluation tool for the studies, with similar risk of a bias tool.