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Record W4410542100 · doi:10.1136/bmj-2024-083865

Core GRADE 5: rating certainty of evidence—assessing indirectness

2025· article· en· W4410542100 on OpenAlexaff
Gordon Guyatt, Alfonso Iorio, Hans de Beer, Andrew Owen, Thomas Agoritsas, M. Hassan Murad, Ganesan Karthikeyan, Carlos A. Cuello‐García, Manya Prasad, Kevin Kim, Dalal S. Ali, Arnav Agarwal, Lars G. Hemkens, Liang Yao, Monica Hultcrantz, Jamie Rylance, Derek K. Chu, Per Olav Vandvik, Benjamin Djulbegović, Reem A. Mustafa, Linan Zeng, Prashanti Eachempati, Bram Rochwerg, Kameshwar Prasad, Víctor M. Montori, Romina Brignardello‐Petersen

Bibliographic record

VenueBMJ · 2025
Typearticle
Languageen
FieldSocial Sciences
TopicDelphi Technique in Research
Canadian institutionsPopulation Health Research InstituteMcMaster UniversityImpact
Fundersnot available
KeywordsCertaintyCore (optical fiber)Computer scienceMedicineInformation retrievalPhilosophyEpistemologyTelecommunications

Abstract

fetched live from OpenAlex

This fifth article in a seven part series presents the Core GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to systematic reviews, clinical practice guidelines, and health technology assessments and addresses issues of indirect evidence. Guideline developers and health technology assessment practitioners must carefully specify the population, intervention, comparison, and outcome (PICO)—their target PICO—and consider the extent to which the best available evidence matches their target. When target and study PICOs differ substantially, studies provide indirect evidence and Core GRADE users may rate down the certainty of evidence as a result of this indirectness. Whether examining studies from a search for direct evidence or a deliberate search for indirect evidence, for each substantial difference between target and study PICO Core GRADE users must judge the likelihood that magnitude of effects will differ substantially. The greater the likelihood of substantial differences the more advisable rating down for indirectness.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.235
metaresearch head score (Gemma)0.624
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesMetaresearch
Consensus categoriesMetaresearch
DomainCandidate signal: Methods · Consensus signal: none
Study designCandidate signal: Theoretical or conceptual · Consensus signal: none
GenreCandidate signal: Methods · Consensus signal: Methods
Teacher disagreement score0.765
Threshold uncertainty score0.943

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.2350.624
Meta-epidemiology (narrow)0.0020.002
Meta-epidemiology (broad)0.0070.017
Bibliometrics0.0230.010
Science and technology studies0.0020.004
Scholarly communication0.0080.007
Open science0.0050.010
Research integrity0.0050.007
Insufficient payload (model declined to judge)0.0150.003

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.610
GPT teacher head0.611
Teacher spread0.001 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; the direct Gemma label and the distilled Codex classifier agree on what is shown here.

Study designTheoretical or conceptual
DomainMethods
GenreMethods

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations14
Published2025
Admission routes1
Has abstractyes

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Same venueBMJSame topicDelphi Technique in ResearchFrench-language works237,207