After performing a systematic review we are looking to assign strength of evidence score using an existing system for cohort studies. Any suggestions for acceptable tools (such as GRADE) would be welcomed - particularly one that a practitioner audience would understand (something simple and straight forward).
Look for a table in : Mangold S (2011) Arten wissenschaftlicher Publikationen. http://www.springer.com/978-3-642-17201-4. Download
(„Online Special“) zu: Evidenzbasiertes Arbeiten in der Physio- und Ergotherapie. Reflektiert - systematisch - wissenschaftlich
fundiert.
Springer Medizin, Berlin, Heidelberg.
I think GRADE is complete, simple and widely used. I would recommend its use
Agreed that GRADE is a good option, although with non-randomised trials you will always downgrade the certainty of the evidence and most likely have only low/very low certainty evidence. You could also use ROBINS for assessing the risk of bias https://methods.cochrane.org/bias/risk-bias-non-randomized-studies-interventions
In my opinion, we should not jump into final recommendations with RCTs, it's primary research. Once systematic reviews are done, of course the information is further processed and reach a stage of recommendation. RCT is just an initial step. Those which critical appraisal skills could still change practice after an RCT, but the widespread recommendation would be deceptive and challenges in reaching outcomes in different sites and patient populations, are not addressed. More about ethics in clinical trial and literature evaluation (a different chapter in the book), please read; Chapter Rajendran N, Thomas D, Madhavan SS, Herman RA. Ethics in Cli...
The tool you use will depend on the study designs. Different study designs require different tools. Some existing tools (i.e. GRADE) gain popularity not because they are better than others. "Today" it is GRADE, "tomorrow" it will be another popular tool. Some tools are more subjective than others. I prefer more objective tools. One easy and recommended tool for longitudinal designs is NOS: Newcastle-Ottawa Quality Assessment Form for Cohort Studies. Another tool is the RoB (Cochrane risk of bias tool) which is more for randomised or controlled studies.
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