GRADE Guidelines: 15. Going From Evidence to Recommendation-Determinants of a Recommendation's Direction and Strength

J Clin Epidemiol. 2013 Jul;66(7):726-35. doi: 10.1016/j.jclinepi.2013.02.003. Epub 2013 Apr 6.

Abstract

In the GRADE approach, the strength of a recommendation reflects the extent to which we can be confident that the composite desirable effects of a management strategy outweigh the composite undesirable effects. This article addresses GRADE's approach to determining the direction and strength of a recommendation. The GRADE describes the balance of desirable and undesirable outcomes of interest among alternative management strategies depending on four domains, namely estimates of effect for desirable and undesirable outcomes of interest, confidence in the estimates of effect, estimates of values and preferences, and resource use. Ultimately, guideline panels must use judgment in integrating these factors to make a strong or weak recommendation for or against an intervention.

MeSH terms

  • Canada
  • Evidence-Based Medicine / standards*
  • Germany
  • Humans
  • Practice Guidelines as Topic / standards*
  • Pulmonary Disease, Chronic Obstructive / economics
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Pulmonary Disease, Chronic Obstructive / rehabilitation*
  • Quality Assurance, Health Care
  • Research Design / standards
  • Risk Assessment
  • Treatment Failure
  • Treatment Outcome
  • United States