Rating certainty of evidence and strength of recommendation

The GRADE (Grading of Recommendation Assessment, Development and Evaluation) approach is a tool that can be used to rate the certainty of your evidence and through this helps you determine the strength of your recommendation. GRADE rates the body of evidence on outcome level, with the certainty ranging from high, moderate, low and very low

Risk of Bias for individual studies

To  cochrane risk of bias tool can be used to assess bias in randomized controlled trials.

The components consists of:

  • Selection bias
    • Random sequence generation
    • Allocation concealment
  • Performance bias
    • Blinding of personell and patients
  • Detection bias
    • Blinding of outcome assessors
  • Attrition bias
    • Incomplete outcome data
  • Reporting bias
    • Selective reporting
  • Other sources of bias

The ROBINS-I tool can be used to assess potential bias in non-randomized controlled studies.

Domains include:

  • Pre-intervention
    • Bias due to confounding
    • Bias in selection of participants
  • At intervention
    • Bias in classification of intervention
  • Post-intervention
    • Bias due to missing data
    • Bias in measurement of outcome
    • Bias in selection of the reported results


Quality of combined evidence

The AGREE website helps you evalute the process of the guideline development and the quality of reporting.

The AMSTAR checklist helps you evaluate the quality of a systematic review.




Import, sort and keep track of your references


Data extract and risk of bias of individual studies


Upload your data, rate the certainty of evidence and make your recommendations


Include all your extracted data and risk of bias into one combined meta-analysis

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