Disclaimer
is pocket guide attempts to define principles of practice that should produce high-quality patient care.
It is applicable to specialists, primary care, and providers at all levels. is pocket guide should not
be considered exclusive of other methods of care reasonably directed at obtaining the same results. e
ultimate judgment concerning the propriety of any course of conduct must be made by the clinician aer
consideration of each individual patient situation. Neither IGC, the medical associations, nor the authors
endorse any product or service associated with the distributor of this clinical reference tool.
Source
Coates LC, Soriano ER, Corp N, et al. Group for Research and Assessment of Psoriasis and
Psoriatic Arthritis (GRAPPA): updated treatment recommendations for psoriatic arthritis 2021.
Nat Rev Rheumatol (2022). https://doi.org/10.1038/s41584-022-00798-0
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Strength of Recommendations in GRADE
a
GRADE
Strength Interpretation
Implications for
clinicians
Implications for
policymakers
Strong
recommendation
for
Almost all informed
patients would choose to
receive the intervention
Should be accepted
by most patients to
whom it is offered
Should be adopted
as policy
Conditional
recommendation
for
Most informed patients
would choose the
intervention, but a sizable
minority would not
Large role for
education and
shared decision-
making
Requires
stakeholder
engagement and
discussion
Conditional
recommendation
against
Most informed patients
would not choose the
intervention, but a small
minority would
Large role for
education and
shared decision-
making
Requires
stakeholder
engagement and
discussion
Strong
recommendation
against
Most patients should not
receive the intervention
Should not be
offered to patients
Should be adopted
as policy
a
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