The GRADE Working Group was established in 2000 as an informal collaboration of methodologists, guideline developers, biostatisticians, clinicians and public health experts.

The GRADE Working Group was formed to discuss and combat the increasing confusion surrounding the wording, recommendations made and evidence behind clinical practice guidelines. The Group resolved to develop a common system for grading the quality of evidence and the strength of recommendations made that is both transparent and sensible. This led to development of the GRADE approach. Over 100 organisations across the world, including WHO, NICE, CDC, AHRQ, NHMRC, JBI and Cochrane have endorsed and/or use GRADE to evaluate the quality of the evidence and strength of recommendations made in clinical practice guidelines.