11
Grading of Recommendations, Assessment, Development,
and Evaluation (GRADE)-Based Recommendations
Implications
for: Strong Recommendation (S) Conditional Recommendation (C)
Patients Most individuals in this
situation would want the
recommended course of action,
and only a small proportion
would not.
e majority of individuals in this
situation would want the suggested
course of action, but many would
not.
Clinicians Most individuals should receive
the intervention. 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.
Recognize that different choices
will be appropriate for individual
patients and that you must
help each patient arrive at a
management decision consistent
with his or her values and
preferences. Decision aids may be
useful in helping individuals to
make decisions consistent with
their values and preferences.
Policy e recommendation can
be adopted as policy in most
situations.
Policymaking will require
substantial debate and involvement
of various stakeholders.
Certainty in the Evidence
High H Low L
Moderate M Very Low VL
Source: Grading of Recommendations Assessment, Development and Evaluation Working Group
(Schunemann HJ et al. Am J Respir Crit Care Med. 2006;174:605–14. Guyatt GH et al. BMJ 2008;
336:924–6).
