GRADE guidelines: 14. Going from evidence to recommendations: The significance and presentation of recommendations

Jeff Andrews, Gordon Guyatt, Andrew D. Oxman, Phil Alderson, Philipp Dahm, Yngve Falck-Ytter, Mona Nasser, Joerg Meerpohl, Piet N. Post, Regina Kunz, Jan Brozek, Gunn Vist, David Rind, Elie A. Akl, Holger J. Schünemann

Research output: Contribution to journalArticlepeer-review

559 Scopus citations

Abstract

This article describes the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to classifying the direction and strength of recommendations. The strength of a recommendation, separated into strong and weak, is defined as the extent to which one can be confident that the desirable effects of an intervention outweigh its undesirable effects. Alternative terms for a weak recommendation include conditional, discretionary, or qualified. The strength of a recommendation has specific implications for patients, the public, clinicians, and policy makers. Occasionally, guideline developers may choose to make "only-in-research" recommendations. Although panels may choose not to make recommendations, this choice leaves those looking for answers from guidelines without the guidance they are seeking. GRADE therefore encourages panels to, wherever possible, offer recommendations.

Original languageEnglish (US)
Pages (from-to)719-725
Number of pages7
JournalJournal of Clinical Epidemiology
Volume66
Issue number7
DOIs
StatePublished - Jul 1 2013

Keywords

  • GRADE
  • Grading
  • Guideline development
  • Quality of evidence
  • Recommendations
  • Strength of evidence

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