GRADE for diagnostic tests and test strategies

The GRADE approach provides a comprehensive and transparent approach for developing recommendations about diagnostic tests or diagnostic strategies.

Diagnostic tests are performed in people with a suspected disorder, with the aim of improving patient relevant health outcomes. These health outcomes are not a direct test result, but follow from the decisions that can be taken based on the test results. For example, a positive test is followed by treatment, and the treatment – if adhered to and effective – improves the health outcomes. Therefore, when evaluating tests, the whole test – treatment pathway needs to be taken into account.

Ideally, recommendations about diagnostic tests are based on direct evidence of the effect of testing, i.e. a direct estimate of the effect of the test on patient important outcomes. When this direct evidence exists, GRADE for interventions can be applied to rate the certainty in the evidence and strength of recommendation. GRADE for diagnostic tests is a comprehensive framework to evaluate the certainty of the evidence when direct evidence of the effect of testing on patient relevant outcomes is not available and linked evidence connects test accuracy to downstream consequences is required for decision-making.

Course objectives

After this course you will:

  • be able to assess and rate the quality of evidence for a diagnostic test or test strategy and to formulate and grade a diagnostic recommendation using the GRADE approach
  • have hands-on experience in using GRADEpro software (freely available via for diagnostic questions, including creating an evidence profile for diagnostic test accuracy

For whom?

  • Guideline developers
  • Systematic reviewers


The topics that will be covered are diagnostic question formulation, assessing the certainty in the evidence and creating evidence profiles for diagnostic test accuracy studies, connecting test accuracy to patient important outcomes and moving from evidence to recommendation.


Interactive presentations and ample time for small group work using GRADEpro software.


  • Experience in developing a systematic review
  • Basic knowledge of the concepts of diagnostic test accuracy
  • Basic knowledge of the GRADE approach (e.g. having attended a basic GRADE workshop)
  • Personal laptop to work with GRADEpro (online software)


Two days from 9.00 to 17.00h. To prepare for the course you will be asked to read a systematic review (part of the training material).


Domus Medica, Utrecht


Miranda Langendam (Amsterdam University Medical Centers / AMC), Hans de Beer (Guide2Guidance) and Ton Kuijpers (NHG), other trainers to be announced.


EUR 525,- per participant. The price includes coffee, lunch and training material.


10 – 18 participants.


Date to be anounced.

More information?

Miranda Langendam (

Cancellation policy

Cancellations made up to three weeks before the start of the course will result in a full refund less minus 30 eur0 to cover administration costs. Refunds for cancellations received after this date will not be made.


The course will be held in English.