19
Grading of Recommendations, Assessment, Development,
and Evaluation (GRADE)-Based Recommendations
Implications
for: Strong Recommendation Conditional Recommendation
Patients Most patients in this situation
would want the recommended
intervention.
e majority of individuals in this
situation would want the suggested
intervention, but many would not.
Clinicians Most patients should receive the
recommended course of action.
Different choices will be
appropriate for different patients,
and that the clinician must
help each patient arrive at a
management decision consistent
with her or his values and
preferences.
Policy Makers e recommendation can
be adapted as policy in most
situations including for the use
as performance indicators.
Policies are also more likely to vary
between regions/health systems.
Performance indicators would have
to focus on the fact that adequate
deliberation about the management
options has taken place.
Certainty in the Evidence
High We are very confident that the true effect lies close to that of the
estimate of the effect.
Moderate We are moderately confident in the effect estimate: e true effect is
likely to be close to the estimate of the effect, but there is a possibility
that it is substantially different
Low Our confidence in the effect estimate is limited: e true effect may be
substantially different from the estimate of the effect.
Very Low We have very little confidence in the effect estimate: e true effect is
likely to be substantially different from the estimate of effect
