 the great framework provides a structured approach to assist the certainty of evidence in systematic reviews. It classifies the evidence into four categories depending on the presence of five downgrading factors and three upgrading factors. Authors must explain why the evidence was graded as it was providing a clear explanation of their reasoning. This helps to increase the transparency of systematic reviews and allows readers to better understand the strength of the evidence presented. This article was authored by Shri Chishau, Lion Zinko, Yenta Huang and others.