16
Table 9. Implications of GRADE Strong and Conditional
Recommendations
Green and bolded: Strong recommendation. A strong recommendation means that the
panel was confident that the desirable effects of following the recommendation outweigh
the undesirable effects (or vice versa), so the course of action would apply to most
patients, and only a small proportion would not want to follow the recommendation.
Yellow and italicized: Conditional recommendation. e desirable effects of following
the recommendation probably outweigh the undesirable effects, so the course of action
would apply to the majority of the patients, but some may not want to follow the
recommendation. Because of this, conditional recommendations are preference sensitive
and always warrant a shared decision-making approach.
Strong
recommendation
Conditional
recommendation
Patients Most people in your situation
would want the recommended
course of action and only a small
proportion would not.
e majority (>50%) of people
in your situation would want the
recommended course of action,
but many would not.
Clinicians Most patients should receive the
recommended course of action.
Be prepared to help patients to
make a decision that is consistent
with their own values.
Policy makers e recommendation can be
adapted as a policy in most
situations.
ere is a need for substantial
debate and involvement of
stakeholders.
Guyatt GH, Oxman AD, Kunz R, Falck-Ytter Y, Vist GE, Liberati A, et al. Going from evidence to
recommendations. BMJ. 2008;336(7652):1049-51.
