Strengths of Recommendations
From the GRADE
working group
Recommendation
("We recommend...")
Suggestion
("We suggest...")
For patients The overwhelming majority
of individuals in this situation
would want the recommended
course of action and only a
small minority would not.
The majority of individuals in
this situation would want the
suggested course of action, but
a sizable minority would not.
For clinicians The overwhelming majority
of individuals should receive
the recommended course of
action. Adherence to this
recommendation according
to the guideline could be
used as a quality criterion or
performance indicator. Formal
decision aids are not likely to
be needed to help individuals
make decisions consistent with
their values and preferences.
Different choices will be
appropriate for different
patients, and you must
help each patient arrive at
a management decision
consistent with her or his
values and preferences.
Decision aids may be useful to
help individuals make decisions
consistent with their values and
preferences. Clinicians should
expect to spend more time with
patients when working toward
a decision.
For policy-makers The recommendation can
be adapted as policy in most
situations, including for use as
performance indicators.
Policy-making will require
substantial debates and
involvement of many
stakeholders. Policies are also
more likely to vary between
regions. Performance indicators
would have to focus on the
fact that adequate deliberation
about the management options
has taken place.