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Evidence-Based Recommendations—GRADE						Print
																Related Pages
										See complete list of GRADE materials linked from MMWR
About GRADE
CDC vaccine recommendations are developed using an explicit evidence-based method based on the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.
Key factors considered in development of recommendations include balance of benefits and harms, type or quality of evidence, values and preferences of the people affected, and health economic analyses.
**An Evidence to Recommendation (EtR) framework**is used to summarize these key factors
ACIP Evidence to Recommendations Framework [7 pages]
ACIP Evidence to Recommendations Framework Users Guide [22 pages]**Evidence tables** are used to summarize the benefits and harms and the strengths and limitations of the body of evidence.
Resources for Learning More About GRADE
GRADE Working Group web site
Full description and answers to frequently asked questions about GRADE
GRADE online learning modules
These online learning modules are designed to help guideline developers and authors of systematic reviews learn how to use the GRADE approach to grade the evidence in systematic reviews, to create Summary of Findings Tables and GRADE Evidence Profiles, and move from evidence to making recommendation
Publications:
Lee G, Carr W, ACIP Evidence-Based Recommendations Work Group. Updated Framework for Development of Evidence-Based Recommendations by the Advisory Committee on Immunization Practices. *MMWR*. 2018;67(45):1271-2.
CDC. New Framework (GRADE) for Development of Evidence-Based Recommendations by the Advisory Committee on Immunization Practices. *MMWR*. 2012;61(18):327.
Matysiak-Klose D, Ahmed F, Duclos P, Falck-Ytter Y, Forland F, Houweling H, et al. Report on the 1st international workshop on procedures for the development of evidence-based vaccination recommendations, Berlin, Germany, 22-23 November 2010 – *Vaccine* 2012;30(14):2399-404.
Ahmed F, Temte JL, Campos-Outcalt D, Schünemann HJ, ACIP Evidence-Based Recommendations Work Group. Methods for developing evidence-based recommendations by the ACIP of the CDC – *Vaccine* 2011;29(49):9171-6.
Handbook:
Ahmed et al. U.S. ACIP Handbook for Developing Evidence-based Recommendations [52 pages]. Version 1.2. Atlanta, GA: Centers for Disease Control and Prevention (CDC); 2013.
Practical handbook for use by ACIP Work Groups in development of evidence-based recommendations for presentation to the Advisory Committee on Immunization Practices.**Top of Page
							
					
							Last Reviewed:  October 23, 2018						Source: 	National Center for Immunization and Respiratory Diseases
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