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  GRADE assessment
HIGH  MODERATE  LOW  VERY LOW 
 
– publication bias is an exception – can only rate down 1 level
• maximum rating down to ‘very low’ certainty
• some concerns with two domains can lead to rating down 1 level
                 • randomized trials start with ‘high’ certainty rating • each domain can be rated down 1 or 2 levels
   An example
Outcome: sleep disruption
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 PRECONGRESS COURSE 17 I VIENNA, AUSTRIA – 23 JUNE 2019 73
   























































































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