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      Erythropoiesis-stimulating agents for anaemia in adults with chronic kidney disease: a network meta-analysis

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          Abstract

          Several erythropoiesis-stimulating agents (ESAs) are available for treating anaemia in people with chronic kidney disease (CKD). Their relative efficacy (preventing blood transfusions and reducing fatigue and breathlessness) and safety (mortality and cardiovascular events) are unclear due to the limited power of head-to-head studies.

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          Most cited references329

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          Measuring inconsistency in meta-analyses.

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            Meta-analysis in clinical trials

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              GRADE guidelines: 3. Rating the quality of evidence.

              This article introduces the approach of GRADE to rating quality of evidence. GRADE specifies four categories-high, moderate, low, and very low-that are applied to a body of evidence, not to individual studies. In the context of a systematic review, quality reflects our confidence that the estimates of the effect are correct. In the context of recommendations, quality reflects our confidence that the effect estimates are adequate to support a particular recommendation. Randomized trials begin as high-quality evidence, observational studies as low quality. "Quality" as used in GRADE means more than risk of bias and so may also be compromised by imprecision, inconsistency, indirectness of study results, and publication bias. In addition, several factors can increase our confidence in an estimate of effect. GRADE provides a systematic approach for considering and reporting each of these factors. GRADE separates the process of assessing quality of evidence from the process of making recommendations. Judgments about the strength of a recommendation depend on more than just the quality of evidence. Copyright © 2011 Elsevier Inc. All rights reserved.
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                Author and article information

                Journal
                Cochrane Database of Systematic Reviews
                Wiley
                14651858
                December 08 2014
                Affiliations
                [1 ]University of Otago Christchurch; Department of Medicine; 2 Riccarton Ave PO Box 4345 Christchurch New Zealand 8140
                [2 ]Mario Negri Sud Consortium; Clinical Pharmacology and Epidemiology; Via Nazionale 8/A Santa Maria Imbaro Chieti Italy 66030
                [3 ]University of Ioannina; Department of Hygiene and Epidemiology, School of Medicine; Panepistimioupoli Ioannina Greece 45110
                [4 ]University of Ioannina; Department of Primary Education; Ioannina Greece
                [5 ]University of Ioannina School of Medicine; Department of Hygiene and Epidemiology; Medical School Campus University of Ioannina Ioannina Greece 45110
                [6 ]The University of Sydney; Sydney School of Public Health; Edward Ford Building A27 Sydney NSW Australia 2006
                [7 ]The Children's Hospital at Westmead; Cochrane Renal Group, Centre for Kidney Research; Westmead NSW Australia 2145
                [8 ]University of Calgary; Department of Medicine; 7th Floor, TRW Building 3280 Hospital Drive NW Calgary AB Canada T2N 4Z6
                [9 ]University of Calgary; Cumming School of Medicine; 7th Floor, TRW Building 3280 Hospital Drive NW Calgary AB Canada T2N 4Z6
                [10 ]University of Alberta; Department of Medicine; 3048 RTF 8308-114 Street NW Edmonton AB Canada T6G 2V2
                [11 ]University of Bari; Department of Emergency and Organ Transplantation; Bari Italy 70100
                [12 ]Mario Negri Sud Consortium; Department of Clinical Pharmacology and Epidemiology; Santa Maria Imbaro Italy
                [13 ]Diaverum; Medical-Scientific Office; Lund Sweden. Amedeo Avogadro University of Eastern Piedmont; Division of Nephrology and Transplantation, Department of Translational Medicine; Novara Italy 28100
                Article
                10.1002/14651858.CD010590.pub2
                6885065
                25486075
                221bee25-a568-4a04-b41f-0b7f73cae5bb
                © 2014
                History

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