G H Guyatt


Affiliation: McMaster University
Country: Canada


  1. Schunemann H, Mustafa R, Brozek J, Santesso N, Bossuyt P, Steingart K, et al. GRADE guidelines: 22. The GRADE approach for tests and strategies-from test accuracy to patient-important outcomes and recommendations. J Clin Epidemiol. 2019;: pubmed publisher
    ..However, because resources and time of guideline developers may be limited, we describe alternative, pragmatic strategies for developing recommendations addressing test use. ..
  2. Saad A, Yekutieli D, Lev Ran S, Gross R, Guyatt G. Getting more out of meta-analyses: a new approach to meta-analysis in light of unexplained heterogeneity. J Clin Epidemiol. 2019;107:101-106 pubmed publisher
    ..Analysing the distribution of an intervention-effect in random-effects models may enable clinicians to improve their understanding of the probability of particular-intervention effects in a new population. ..
  3. Morgan R, Thayer K, Santesso N, Holloway A, Blain R, Eftim S, et al. Evaluation of the risk of bias in non-randomized studies of interventions (ROBINS-I) and the 'target experiment' concept in studies of exposures: Rationale and preliminary instrument development. Environ Int. 2018;120:382-387 pubmed publisher
  4. Elwyn G, Quinlan C, MULLEY A, Agoritsas T, Vandvik P, Guyatt G. Trustworthy guidelines - excellent; customized care tools - even better. BMC Med. 2015;13:199 pubmed publisher
    ..We observe two processes occurring: first, is the recognition that decision making in healthcare requires collaboration and deliberation, and second, to achieve this, we need tools designed to customize care at the level of individuals. ..
  5. request reprint
    Guyatt G, Norman G, Juniper E, Griffith L. A critical look at transition ratings. J Clin Epidemiol. 2002;55:900-8 pubmed
    ..Investigators using transition scores should ensure their validity by exploring relationships with pre and post scores of corresponding domain scores. ..
  6. Carrasco Labra A, Brignardello Petersen R, Santesso N, Neumann I, Mustafa R, Mbuagbaw L, et al. Comparison between the standard and a new alternative format of the Summary-of-Findings tables in Cochrane review users: study protocol for a randomized controlled trial. Trials. 2015;16:164 pubmed publisher
    ..NCT02022631 (21 December 2013). ..
  7. Zhang Y, Zhang S, Thabane L, Furukawa T, Johnston B, Guyatt G. Although not consistently superior, the absolute approach to framing the minimally important difference has advantages over the relative approach. J Clin Epidemiol. 2015;68:888-94 pubmed publisher
    ..Researchers may consider the absolute as a default but also compare both methods on an instrument by instrument basis. ..
  8. Fowler R, Mittmann N, Geerts W, Heels Ansdell D, Gould M, Guyatt G, et al. Economic evaluation of the prophylaxis for thromboembolism in critical care trial (E-PROTECT): study protocol for a randomized controlled trial. Trials. 2014;15:502 pubmed publisher
    ..Clinicaltrials.gov Identifier: NCT00182143 . Date of registration: 10 September 2005. ..
  9. Guyatt G, Eikelboom J, Gould M, Garcia D, Crowther M, Murad M, et al. Approach to outcome measurement in the prevention of thrombosis in surgical and medical patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141:e185S-e194S pubmed publisher
    ..All approaches have their limitations. The optimal choice of approach depends on the nature of the evidence available. ..

More Information


  1. Akl E, Kahale L, Agoritsas T, Brignardello Petersen R, Busse J, Carrasco Labra A, et al. Handling trial participants with missing outcome data when conducting a meta-analysis: a systematic survey of proposed approaches. Syst Rev. 2015;4:98 pubmed publisher
    ..Although these approaches require further testing, they may guide review authors in addressing missing participant data. ..
  2. Yonemoto N, Tanaka S, Furukawa T, Kato T, Mantani A, Ogawa Y, et al. Strategic use of new generation antidepressants for depression: SUN(^_^) D protocol update and statistical analysis plan. Trials. 2015;16:459 pubmed publisher
    ..This paper presents the updated protocol and the detailed statistical analysis plan for the SUN(^_^)D trial in order to avoid reporting bias and data-driven results. ClinicalTrials.gov: NCT01109693 (registered on 21 April 2010). ..
  3. Guyatt G, Oxman A, Montori V, Vist G, Kunz R, Brozek J, et al. GRADE guidelines: 5. Rating the quality of evidence--publication bias. J Clin Epidemiol. 2011;64:1277-82 pubmed publisher
    ..Publication bias is likely frequent, and caution in the face of early results, particularly with small sample size and number of events, is warranted. ..
  4. Guyatt G, Oxman A, Kunz R, Brozek J, Alonso Coello P, Rind D, et al. GRADE guidelines 6. Rating the quality of evidence--imprecision. J Clin Epidemiol. 2011;64:1283-93 pubmed publisher
    ..If the 95% CI includes appreciable benefit or harm (we suggest an RR of under 0.75 or over 1.25 as a rough guide) rating down for imprecision may be appropriate even if OIS criteria are met. ..
  5. Guyatt G, Oxman A, Santesso N, Helfand M, Vist G, Kunz R, et al. GRADE guidelines: 12. Preparing summary of findings tables-binary outcomes. J Clin Epidemiol. 2013;66:158-72 pubmed publisher
  6. Florez I, Al Khalifah R, Sierra J, Granados C, Yepes Nuñez J, Cuello García C, et al. The effectiveness and safety of treatments used for acute diarrhea and acute gastroenteritis in children: protocol for a systematic review and network meta-analysis. Syst Rev. 2016;5:14 pubmed publisher
    ..The results will help to reduce the uncertainty of the effectiveness of the interventions, find knowledge gaps, and/or encourage further research for other therapeutic options. PROSPERO registration number: CRD42015023778. ..
  7. Carles M, Brosa M, Souto J, Garcia Alamino J, Guyatt G, Alonso Coello P. Cost-effectiveness analysis of dabigatran and anticoagulation monitoring strategies of vitamin K antagonist. BMC Health Serv Res. 2015;15:289 pubmed publisher
    ..Our analyses contrast with the available cost analysis of dabigatran and usual care of anticoagulated patients. ..
  8. Guyatt G, Oxman A, Akl E, Kunz R, Vist G, Brozek J, et al. GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol. 2011;64:383-94 pubmed publisher
    ..Subsequent articles in this series will address GRADE's approach to formulating questions, assessing quality of evidence, and developing recommendations. ..
  9. Guyatt G, Oxman A, Kunz R, Jaeschke R, Helfand M, Liberati A, et al. Incorporating considerations of resources use into grading recommendations. BMJ. 2008;336:1170-3 pubmed publisher
  10. Guyatt G, Oxman A, Schunemann H, Tugwell P, Knottnerus A. GRADE guidelines: a new series of articles in the Journal of Clinical Epidemiology. J Clin Epidemiol. 2011;64:380-2 pubmed publisher
    ..gradeworkinggroup.org/), attests to the importance of this work. This article introduces a 20-part series providing guidance for the use of GRADE methodology that will appear in the Journal of Clinical Epidemiology. ..
  11. Morgan R, Thayer K, Bero L, Bruce N, Falck Ytter Y, Ghersi D, et al. GRADE: Assessing the quality of evidence in environmental and occupational health. Environ Int. 2016;92-93:611-6 pubmed publisher
    ..The objectives of this article are to provide an overview of GRADE, discuss GRADE's applicability to environmental health, and identify priority areas for method assessment and development. ..
  12. Sekercioglu N, Busse J, Mustafa R, Guyatt G, Thabane L. Cinacalcet versus standard treatment for chronic kidney disease: a protocol for a systematic review and meta-analysis. Syst Rev. 2016;5:2 pubmed publisher
    ..The results of this systematic review will help guide management of this patient population, and identify targets for future research. PROSPERO CRD42015020318 http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42015020318. ..
  13. Guyatt G, Oxman A, Vist G, Kunz R, Brozek J, Alonso Coello P, et al. GRADE guidelines: 4. Rating the quality of evidence--study limitations (risk of bias). J Clin Epidemiol. 2011;64:407-15 pubmed publisher
    ..Rather, for any individual outcome, when there are some studies with a high risk, and some with a low risk of bias, they should consider including only the studies with a lower risk of bias. ..
  14. Fulone I, Barberato Filho S, dos Santos M, Rossi C, Guyatt G, Lopes L. Essential psychiatric medicines: wrong selection, high consumption and social problems. BMC Public Health. 2016;16:52 pubmed publisher
  15. Guyatt G, Oxman A, Kunz R, Woodcock J, Brozek J, Helfand M, et al. GRADE guidelines: 8. Rating the quality of evidence--indirectness. J Clin Epidemiol. 2011;64:1303-10 pubmed publisher
  16. Yepes Nuñez J, Zhang Y, Xie F, Alonso Coello P, Selva A, Schunemann H, et al. Forty-two systematic reviews generated 23 items for assessing the risk of bias in values and preferences' studies. J Clin Epidemiol. 2017;85:21-31 pubmed publisher
    ..The items and domains identified provide insight into issues of RoB in patients' values and preference studies and establish the basis for an instrument to assess RoB in such studies. ..
  17. Zhang Y, Alyass A, Vanniyasingam T, Sadeghirad B, Florez I, Pichika S, et al. A systematic survey of the methods literature on the reporting quality and optimal methods of handling participants with missing outcome data for continuous outcomes in randomized controlled trials. J Clin Epidemiol. 2017;88:67-80 pubmed publisher
    ..Simulation studies addressing methods to deal with MPD suffered from serious limitations. The mixed model approach was superior to other methods in terms of overall performance and bias. LOCF performed worst. ..
  18. Guyatt G, Oxman A, Kunz R, Atkins D, Brozek J, Vist G, et al. GRADE guidelines: 2. Framing the question and deciding on important outcomes. J Clin Epidemiol. 2011;64:395-400 pubmed publisher
  19. Guyatt G, Thorlund K, Oxman A, Walter S, Patrick D, Furukawa T, et al. GRADE guidelines: 13. Preparing summary of findings tables and evidence profiles-continuous outcomes. J Clin Epidemiol. 2013;66:173-83 pubmed publisher
    ..We outline the merits and limitations of each alternative and provide guidance for meta-analysts and guideline developers. ..
  20. Guyatt G, Oxman A, Kunz R, Woodcock J, Brozek J, Helfand M, et al. GRADE guidelines: 7. Rating the quality of evidence--inconsistency. J Clin Epidemiol. 2011;64:1294-302 pubmed publisher
  21. Guyatt G, Oxman A, Sultan S, Glasziou P, Akl E, Alonso Coello P, et al. GRADE guidelines: 9. Rating up the quality of evidence. J Clin Epidemiol. 2011;64:1311-6 pubmed publisher
    ..Other considerations include the rapidity of the response, the underlying trajectory of the condition, and indirect evidence. ..
  22. Mbuagbaw L, Rochwerg B, Jaeschke R, Heels Andsell D, Alhazzani W, Thabane L, et al. Approaches to interpreting and choosing the best treatments in network meta-analyses. Syst Rev. 2017;6:79 pubmed publisher
    ..We present ranking approaches' merits and limitations and provide an example of how to apply the results of a NMA to clinical practice. ..
  23. Zhang Y, Florez I, Colunga Lozano L, Aloweni F, Kennedy S, Li A, et al. A systematic survey on reporting and methods for handling missing participant data for continuous outcomes in randomized controlled trials. J Clin Epidemiol. 2017;88:57-66 pubmed publisher
    ..Most RCTs failed to use optimal analytic methods, and very few conducted sensitivity analyses addressing the possible impact of MPD or commented on how MPD might influence risk of bias. ..
  24. Brignardello Petersen R, Bonner A, Alexander P, Siemieniuk R, Furukawa T, Rochwerg B, et al. Advances in the GRADE approach to rate the certainty in estimates from a network meta-analysis. J Clin Epidemiol. 2018;93:36-44 pubmed publisher