This article is the last of a series providing guidance for the use of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system for rating the quality of evidence and grading the strength of recommendations in systematic reviews and clinical practice guidelines. Formulating recommendations with the applicable evidence can be difficult due to the large and diverse nature of guideline committees. This article describes a simple technique called the GRADE grid for clarifying the opinions from guideline panels, dealing with disagreement, and achieving consensus among guideline panels. The grid may be helpful for any guideline groups who want to use GRADE to develop their guidelines and achieve consensus or understand the patterns of uncertainty that surround the interpretation of scientific evidence.