Monica Hultcrantz

1 month ago | bmj.com | Gordon Guyatt |Alfonso Iorio |Hans de Beer |Andrew Owen |Thomas Agoritsas |M Hassan Murad | +11 more

Research Methods & Reporting Core GRADE: Indirectness BMJ 2025; 389 doi: https://doi.org/10.1136/bmj-2024-083865 Cite this as: BMJ 2025;389:e083865 Gordon Guyatt, distinguished professor1 2 3, Alfonso Iorio, professor1 2, Hans De Beer, methodologist4, Andrew Owen, professor5, Thomas Agoritsas, professor1 3 6, M Hassan Murad, professor7, Ganesan Karthikeyan, professor, executive director8 9, Carlos Cuello, assistant professor1, Manya Prasad, associate professor10, Kevin Kim, methodologist1 11,...

Mar 5, 2025 | ebm.bmj.com | Linan Zeng |Monica Hultcrantz |David Tovey |Nancy Santesso

DiscussionThis article has, using hypothetical and actual examples, introduced the challenges that arise when authors initially decide to rate certainty in a non-zero effect and the point estimate falls close to the null. Our suggested approach considers whether the point estimate is certainly or possibly less than the MID: if certainly so (ie, clearly smaller than the smallest plausible MID), we suggest revising to rate certainty in a little or no effect.