Application of the GRADE method in public health: a bibliometric study of the 87 systematic reviews in Cochrane Library

Article type
Authors
Guo K1, Li X1, Yang K1
1Lanzhou University
Abstract
Background: Grading of Recommendations, Assessment, Development and Evaluation (GRADE) method has been used in many fields, and its application in public health can be more conducive to its development.

Objectives: To analyze the main features of the 87 systematic reviews about public health in Cochrane Library published from 2000 to February, 2020.

Methods: We mainly analyze 87 systematic reviews about public health in Cochrane, and mainly analyze the outcomes of each review and the application of GRADE method: Including the number of outcomes and which evaluated by the GRADE method, and analyzing the grade classification (high, moderate, low, very low) and promotion or degradation factors of GRADE. Other analysis including AMSTAR scores for each review and information on year of publication, contributing authors, institutions and countries, study design of included studies, topic of the article and keywords was extracted. VOS viewer and Bibliographic Items Co-occurrence Matrix Builder (BICOMB) were used for plotting or statistics of authors and keywords.

Results: The 87 articles of public health in Cochrane Library were published from 2000 to 2020, which were mainly published in 2019 (n=13), 2016 (n=11) and 2018 (n=8). Among 396 authors, the greatest number of articles was associated with three individuals namely Ker K (n = 6), Verbeek J (n = 5) and Pena J (n = 5). Most articles have been published in the United Kingdom (n=33), Australia (n=14) and the United States (n=10). The most published institution is London School of Health and Tropical Medicine (n=6), All reviews included mainly randomized controlled trials (RCTs), others were non-RCTs, interrupted time series (ITS), and controlled before-after (CBA) studies. Among 479 unique keywords, infant or child (n = 49), RCTs (n = 46), adult (n=25), adolescent (n=19) and female or pregnancy (n=18) were the most frequently used. 41 of the 87 reviews used the GRADE method. The total number of outcomes in all articles was 578, outcomes evaluated by the GRADE method was 498, including high level (n=23), moderate level (n=100), low level (n=178), very low level (n=197). Most articles have an AMSTAR score of around 9.

Conclusions: This study has revealed that reviews in the field of public health are constantly increasing, especially in recent years (year from 2016 to 2019). The application of the GRADE method to the evaluation of different outcomes has become more and more widespread over time.