GRADE Assessment

Rate evidence quality systematically

GRADE in worksheets is a chore. mapped walks you through every downgrade and upgrade factor per outcome, pulls from your risk-of-bias and meta-analysis data automatically, and outputs Cochrane-format Summary of Findings tables ready for your manuscript.

Updated April 2026

mapped's GRADE Assessment rates evidence certainty per outcome — High, Moderate, Low, or Very Low — using the standardized GRADE approach. The workflow walks you through five downgrade factors (risk of bias, inconsistency, indirectness, imprecision, publication bias) and three upgrade factors (large effect, dose-response, residual confounding) for each outcome. Risk-of-bias and meta-analysis data feed in automatically. Output is a Cochrane-format Summary of Findings table with effect estimates, certainty ratings, and footnoted rationales — ready for direct manuscript insertion.

GRADE Assessment

Evidence Quality Rating

SPSarah

GRADE Assessment

Rate the certainty of evidence for each outcome using the GRADE framework

Step 4 / 5
1Collect
2Outcomes
3Assess
4Summary
5Export
⊕⊕⊕⊕High
0
⊕⊕⊕⊖Moderate
0
⊕⊕⊖⊖Low
1
⊕⊖⊖⊖Very Low
3
Evidence Profile
AI-Assisted
Certainty assessmentSummary of findings
OutcomeNo. of studiesRisk of biasInconsistencyIndirectnessImprecisionOtherNo. of patientsRelative (95% CI)Absolute (95% CI)Certainty
IVUS-guidedConventional angiography
All-cause death
all_cause_death
10 RCTsseriousanot seriousseriouscseriousdnone4,8684,867RR 0.88 (0.72 to 1.08)2 fewer per 1,000 (from 6 fewer to 2 more)⊕⊖⊖⊖Very Low
Target vessel revascularization
tvr
10 RCTsseriousaseriousbnot seriousnot seriousnone5,4685,468RR 0.66 (0.50 to 0.87)24 fewer per 1,000 (from 35 fewer to 9 fewer)⊕⊕⊖⊖Low
MACE composite
mace_composite
11 RCTsseriousaseriousbnot seriousnot seriousPub. bias −1e3,8823,882RR 0.68 (0.52 to 0.89)32 fewer per 1,000 (from 48 fewer to 11 fewer)⊕⊖⊖⊖Very Low
Cardiac death
cardiac_death
11 RCTsseriousaseriousbseriouscseriousdnone5,5245,524RR 0.71 (0.46 to 1.10)6 fewer per 1,000 (from 12 fewer to 2 more)⊕⊖⊖⊖Very Low

CI: confidence interval; RR: risk ratio; I² between-study heterogeneity; τ² between-study variance. GRADE certainty: ⊕⊕⊕⊕ High · ⊕⊕⊕⊖ Moderate · ⊕⊕⊖⊖ Low · ⊕⊖⊖⊖ Very low.

Explanations
  • a.Risk of bias — downgraded one level; ≥1 RoB 2 domain rated Some concerns / High across the contributing RCTs.
  • b.Inconsistency — downgraded one level; substantial heterogeneity (MACE composite I² = 71%).
  • c.Indirectness — downgraded one level; surrogate-weighted comparator population vs the target indication.
  • d.Imprecision — downgraded one level; 95% CI spans the no-effect line; optimal information size not met.
  • e.Publication bias — downgraded one level; funnel-plot asymmetry (Egger's p < 0.10).
Downgrade rationale · MACE composite⊕⊖⊖⊖ Very Low
−1 Risk of Bias−1 InconsistencyIndirectnessImprecision−1 Publication Bias
AI rationale: I² = 71% (substantial heterogeneity); 7/12 studies rated Some Concerns or High RoB; mild small-study effect on funnel plot.
© 2026 Mapped Technologies LLC. All rights reserved.
GRADE 4-level rating per outcome
5 downgrade factors with structured rationale
3 upgrade factors for observational evidence
Cochrane-format Summary of Findings tables
Auto-pulls effect estimates from meta-analysis + RoB
Word / PDF / LaTeX export

Key Capabilities

Per-Outcome Evidence Rating

Rate evidence as High, Moderate, Low, or Very Low per outcome — not per study, not per review. mapped starts each rating from study design (RCTs at High; observational at Low) and walks you through downgrade and upgrade factors with the source data already attached.

Five Downgrade Factors

Risk of bias (auto-populated from your RoB assessments), inconsistency (auto-flagged from I² and Q), indirectness (population, intervention, comparator, outcome relevance), imprecision (CI width, optimal information size), and publication bias (Egger's, funnel-plot asymmetry). Each factor downgrades by 1 or 2 levels with documented rationale.

Three Upgrade Factors

Large effect (RR ≤ 0.5 or ≥ 2 with no plausible confounders), dose-response gradient, and residual confounding that would reduce rather than increase the effect. Used selectively to upgrade observational evidence with strong, consistent findings — captured per outcome with rationale.

Outcome Prioritization

Mark each outcome as Critical, Important, or Limited importance. mapped focuses GRADE attention on critical and important outcomes — the patient-relevant ones that should drive recommendations — and surfaces them at the top of the Summary of Findings table.

Cochrane-Format Summary of Findings Tables

SoF tables auto-generate with effect estimates from your meta-analysis, GRADE certainty per outcome, absolute and relative effects, number of participants and studies, and footnoted rationales for each downgrade or upgrade. Format follows Cochrane standards; structure goes straight into your manuscript.

Integrated Export

GRADE assessments and SoF tables export to Word (.docx), PDF, or LaTeX — and integrate directly with the manuscript module so the SoF table is inserted at the right section automatically. No copying between tools, no formatting drift.

Frequently asked questions

What is mapped's GRADE Assessment?
It's the GRADE evidence-certainty workflow built into mapped. You rate each outcome High / Moderate / Low / Very Low using five downgrade and three upgrade factors. Risk-of-bias and meta-analysis data populate automatically; the output is a Cochrane-format Summary of Findings table.
How does mapped's GRADE differ from GRADEpro GDT?
GRADEpro GDT is the official GRADE working group tool — feature-rich and widely used. mapped's advantage is integration: your risk-of-bias, meta-analysis effect estimates, and heterogeneity statistics flow into GRADE automatically rather than being re-entered. For mapped users, it's one less context switch.
Does mapped auto-populate downgrade factors?
Partially. Risk of bias pulls directly from your RoB assessments. Inconsistency is suggested from I² and Q. Imprecision is suggested from confidence-interval width. Publication bias pulls from Egger's and funnel-plot results. Indirectness and the upgrade factors require your judgement — mapped surfaces the question, you decide.
Who is GRADE Assessment for?
Any systematic review reporting evidence-based recommendations — Cochrane reviews, clinical-practice-guideline panels, HTA reports, BMJ Best Practice authors. If your audience expects per-outcome certainty ratings and a Summary of Findings table, this module saves hours per outcome.
How much does GRADE Assessment cost?
Included in every Mapped Project (list $119/project, currently $79 launch pricing) with auto-generated SoF tables. Custom Enterprise plans add unlimited projects across the team. See mappedresearch.com/pricing.
Does mapped support GRADE for diagnostic-accuracy evidence?
Yes — GRADE for DTA reviews follows the modified GRADE approach with diagnostic-specific imprecision and indirectness criteria. mapped uses the right rubric automatically when the project is set up as a DTA review (added in the April 2026 release alongside the 5-study-types feature).

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