Earlier this year, a paper in the Journal of Clinical Epidemiology argued that ‘the GRADE approach to evidence matters now, perhaps more than ever’. Dr Sue Brennan couldn’t agree more. Having been increasingly involved in the world of GRADE for over a decade, she is well placed to look back on recent achievements and plan for the challenges that lie ahead at local, national and international levels.
Just last month, Sue was elected to the influential GRADE Guidelines Group (GGG) – the 12 member executive of the global GRADE Working Group. Her successful nomination reflects the many contributions she continues to make to the interconnected worlds of research synthesis, methods and guideline development. Among other things, Sue established and is the director of the Melbourne GRADE Centre, and works closely with policy makers and guideline developers to implement GRADE methods for assessing research and making evidence-based recommendations. In a nutshell, she has a longstanding interest in all things GRADE and looks forward to taking up the many new opportunities her election opens up.
‘I’m really honoured to be elected to the GRADE Guidelines Group and have this incredible opportunity to work alongside global leaders who pioneered work in this field. It’s an extraordinary time to be involved in evidence synthesis, methods and guideline development,’ Sue says. ‘From the outset of the COVID-19 pandemic, two things were really clear – just how rapidly we needed high-quality evidence and just how essential it was to have mechanisms in place to identify, synthesise and apply it. It was incredibly important to have people ready on the ground around the world equipped with trusted, transparent methods and tools to enable this to happen – without cutting corners or taking shortcuts. That’s what GRADE contributors have clearly demonstrated and delivered around the world throughout this year.’
‘There are many practical examples of this. Here in Australia, the National COVID-19 Clinical Evidence Taskforce had the skills and capacity to apply GRADE methods locally to rapidly produce trusted living guidelines. Similarly, in the US and Canada, GRADE contributors led guideline development and systematic reviews for WHO on key questions, like the Lancet paper on masks and social distancing for instance. The living WHO guideline on drugs for covid-19 update just published as part of the BMJ Rapid Recommendations series also exemplifies the GRADE approach and the benefits it brings. These are just a handful of many other examples from around the world.’
‘Looking ahead, I think my new role will see the Melbourne GRADE Centre work much more closely with the global GRADE Working Group, which is an amazing network of people. I’m keen to share the experiences of the people we work with locally with the GGG – so we can discuss and address some of the practical challenges that health decision-makers in our region face when applying GRADE to complex public health problems.’
‘It will be great to be involved in this kind of exchange of ideas and experiences, given we’ll have a closer line of communication to influence some of the directions that GRADE takes centrally, and make sure we reflect what's going on locally. The NHMRC has such a significant involvement in public health decision-making here in Australia, and really lead national efforts to ensure best-practice in the development of health guidance. I know these are areas that the GRADE Working Group is giving a lot of attention to. This level of commitment means we have a lot to offer in having representation on the GGG from our region.'
'Ultimately though, as we’ve seen this year, GRADE is a truly global and collaborative network. I look forward to becoming even more involved, especially at a time when, as my colleagues noted earlier this year, GRADE methods and approaches to evidence matter more than ever.'
GRADE (which stands for Grading of Recommendations, Assessment, Development and Evaluations) provides a transparent and systematic approach to interpreting evidence and evidence-based making recommendations. GRADE methods can be used to communicate the level of confidence in intervention effects, test accuracy, risk and prognostic factors, consequences of public health measures, and qualitative bodies of evidence. It’s the most widely adopted tool for interpreting and grading the quality of evidence worldwide, and is used by over 100 leading organisations, including Cochrane, WHO and National Health and Medical Research Council (NHMRC).