**Possible ways of setting thresholds or ranges and what the certainty expressed will represent**

Settingprimarily for |
Degree of contextualization |
Threshold or range |
How it is set |
What the certainty rating represents |

Systematic reviews and HTA |
Noncontextualized |
Range: 95% Confidence Interval |
Using existing limits of the 95% CIs, which implies precision is not routinely part of the rating | Certainty that the effect lies within the confidence interval |

OR ‚ 1, RR ‚ 1, HR‚ 1, RD ‚ 0 |
Using the threshold of null effectg | Certainty that the effect of one treatment differs from another | ||

Systematic reviews and HTA |
Partially contextualized
| Specified magnitude of effect |
E.g. a small effect can be defined as an effect small enough that one might consider not using the intervention if adverse effects or costs are appreciable | Certainty in a specified magnitude of effect for one outcome (e.g. no or trivial, small, moderate or large effect) |

Clinical practice guideline |
Fully contextualized |
Threshold determined with considerations of all critical outcomes |
Considering the range of possible effects on all critical outcomes, bearing in mind the decision(s) that need to be made, and the associated values and preferences | For each outcome, ratings represent our confidence that the direction of the net effect (positive or negative) will not differ from one end of the certainty range to the other. |

HTA: Health technology assessment

Hulcrantz M, et al. The GRADE Working Group clarifies the construct of certainty of evidence. JCE 2017