GRADE workshop therapy

Judgments about evidence and recommendations in healthcare are complex. Systematic reviews of the effects of healthcare provide essential, but not sufficient information for making well informed decisions. Reviewers and people who use reviews draw conclusions about the quality of the evidence, either implicitly or explicitly. Such judgments guide subsequent decisions. For example, clinical actions are likely to differ depending on whether one concludes that the evidence that warfarin reduces the risk of stroke in patients with atrial fibrillation is convincing (high quality) or that it is unconvincing (low quality).
Similarly, practice guidelines and people who use them draw conclusions about the strength of recommendations, either implicitly or explicitly. A guideline that recommends that patients with atrial fibrillation should be treated may suggest that all patients definitely should be treated or that patients should probably be treated, implying that treatment may not be warranted in all patients.

A systematic and explicit approach to making judgments such as these can help to prevent errors, facilitate critical appraisal of these judgments, and can help to improve communication of this information. The Grading of Recommendations Assessment, Development and Evaluation (short GRADE) Working Group ( began in the year 2000 as an informal collaboration of people with an interest in addressing the shortcomings of present grading systems in health care. The working group has developed a common, sensible and transparent approach to grading quality of evidence and strength of recommendations. Many international organizations (for example NICE, Cochrane Collaboration, WHO) have provided input into the development of the approach and have started using it. Anno 2014, GRADE has become the gold standard as method for developing evidence-based recommendations.

Course objectives

After this course you:

  • will be able to assess and rate the quality of evidence for a therapeutic intervention and to formulate and grade a recommendation using the GRADE approach
  • will have hands-on experience in using GRADE software (Guideline Development Tool, online and available for free via ) to create an evidence profile for a therapeutic intervention based on a systematic review.
  • will be up to date on recent developments in the GRADE approach

For whom?

  • Guideline developers
  • Systematic reviewers


After an introduction on the theory of GRADE, the workshop will be ‘hands-on’ with ample time to practice with the method. We will conclude the day with a brief overview of new developments in GRADE.


  • Basic knowledge of developing a systematic review and critical appraisal of clinical trials
  • Personal laptop to work with the online Guideline Development Tool (GDT)


1 full day (8 hours). To prepare for the course you will be asked to read a systematic review (part of the training material).


Hans de Beer (Guide2Guidance), Ton Kuijpers (NHG), Miranda Langendam (AMC), Lotty Hooft and Rob Scholten (Cochrane Netherlands). The trainers are active members of the international GRADE Working Group.


EUR 325,- per participant. The price includes coffee, lunch and training material.


10 – 18 participants.


Wednesday November 20, 2019, 9.00 to 17.00h, Utrecht


More information?

About the course and registration:

Ton Kuijpers (
Miranda Langendam (

Cancellation policy

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


Accreditation is 7 hours for general practioners. Please check for more information.


Course will be held in English in case of non-Dutch speaking participants.