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. 2014 Aug 18;2014:1709.

Table.

GRADE Evaluation of interventions for Squamous cell carcinoma of the skin (non-metastatic).

Important outcomes Incidence rates
Studies (Participants) Outcome Comparison Type of evidence Quality Consistency Directness Effect size GRADE Comment
Does the use of sunscreen help prevent cutaneous squamous cell carcinoma and actinic (solar) keratosis?
1 (1621) Incidence rates Regular sunscreen use versus discretionary or no use 4 0 0 –1 0 Moderate Directness point deducted for restricted population (subtropical)
1 (588) Incidence rates Daily sunscreen use versus placebo 4 0 0 –1 0 Moderate Directness point deducted for restricted population (all participants had previous actinic [solar] keratoses)
1 (1621) Incidence rates Regular sunscreen use versus discretionary or no use 4 0 0 –1 0 Moderate Directness point deducted for restricted population (subtropical, half of participants had previous actinic [solar] keratoses)

We initially allocate 4 points to evidence from RCTs, and 2 points to evidence from observational studies. To attain the final GRADE score for a given comparison, points are deducted or added from this initial score based on preset criteria relating to the categories of quality, directness, consistency, and effect size. Quality: based on issues affecting methodological rigour (e.g., incomplete reporting of results, quasi-randomisation, sparse data [<200 people in the analysis]). Consistency: based on similarity of results across studies. Directness: based on generalisability of population or outcomes. Effect size: based on magnitude of effect as measured by statistics such as relative risk, odds ratio, or hazard ratio.