Response to Commentary by Mattos et al. (2024)

Replies to comments made by Mattos et al. (see record 2025-49982-003) on the original article (see record 2024-19816-001). Mattos et al. critiqued our assessments of the certainty of evidence as being overly permissive and not adhering to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group's guidelines. GRADE has become an international standard to describe the level of confidence that investigators have in estimates of effects. Like the risk of bias evaluations, determining the certainty of evidence involves subjective judgment. The true value of GRADE is not in yielding a definitive evidence certainty rating but in its emphasis on transparency. While we acknowledge and respect the differing viewpoints of Mattos et al. regarding our ratings, we caution against the rigid and formulaic use of the GRADE methodology. (PsycInfo Database Record (c) 2024 APA, all rights reserved).