Toggle Main Menu Toggle Search

Open Access padlockePrints

The use of Bayesian networks to assess the quality of evidence from research synthesis: 2. Inter-rater reliability and Comparison with standard GRADE assessment

Lookup NU author(s): Dr Gavin Stewart



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© 2015 Llewellyn et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Background: The grades of recommendation, assessment, development and evaluation (GRADE) approach is widely implemented in systematic reviews, health technology assessment and guideline development organisations throughout the world. We have previously reported on the development of the Semi-Automated Quality Assessment Tool (SAQAT), which enables a semi-automated validity assessment based on GRADE criteria. The main advantage to our approach is the potential to improve inter-rater agreement of GRADE assessments particularly when used by less experienced researchers, because such judgements can be complex and challenging to apply without training. This is the first study examining the interrater agreement of the SAQAT. Methods: We conducted two studies to compare: a) the inter-rater agreement of two researchers using the SAQAT independently on 28 meta-analyses and b) the inter-rater agreement between a researcher using the SAQAT (who had no experience of using GRADE) and an experienced member of the GRADE working group conducting a standard GRADE assessment on 15 meta-analyses. Results: There was substantial agreement between independent researchers using the Quality Assessment Tool for all domains (for example, overall GRADE rating: weighted kappa 0.79; 95% CI 0.65 to 0.93). Comparison between the SAQAT and a standard GRADE assessment suggested that inconsistency was parameterised too conservatively by the SAQAT. Therefore the tool was amended. Following amendment we found fair-to-moderate agreement between the standard GRADE assessment and the SAQAT (for example, overall GRADE rating: weighted kappa 0.35; 95% CI 0.09 to 0.87). Conclusions: Despite a need for further research, the SAQAT may aid consistent application of GRADE, particularly by less experienced researchers.

Publication metadata

Author(s): Llewellyn A, Whittington C, Stewart G, Higgins JPT, Meader N

Publication type: Article

Publication status: Published

Journal: PLoS ONE

Year: 2015

Volume: 10

Issue: 12

Online publication date: 30/12/2015

Acceptance date: 03/03/2015

Date deposited: 20/07/2017

ISSN (electronic): 1932-6203

Publisher: Public Library of Science


DOI: 10.1371/journal.pone.0123511


Altmetrics provided by Altmetric