A guide and pragmatic considerations for applying GRADE to network meta-analysis

Assessing the certainty of the evidence from network meta-analyses (NMAs) using the GRADE approach requires a thorough understanding of the methods and a substantial workload This article describes a step-by-step process for assessing the certainty of the evidence of each comparison in an NMA Practical strategies are also described, such as rule setting and automation, which can facilitate implementation of the GRADE approach in the entire network By following the proposed approach and incorporating tools that facilitate the tasks, reviewers will achieve a substantial reduction in the workload without compromising the rigor