GRADEing the un-GRADE-able: a description of challenges in applying GRADE methods to the ethical and implementation questions of pediatric organ donation guidelines

Good practice statements (GPSs) have been proposed by the GRADE working group as a way of avoiding the inappropriate characterization of evidence as low quality in support of strong recommendations justified by indirect evidence. This commentary examines how the GPS methodology was applied to the development of a recent guideline for pediatric deceased donation after circulatory determined death. This guideline was informed by a broad body of …