Developing clinical practice guidelines: types of evidence and outcomes; values and economics, synthesis, grading, and presentation and deriving recommendations

Table 3 Implications of the two grades of strength of recommendations in the GRADE approach

Target group	Strong recommendations*	Conditional (weak) recommendations
Patients	Most people in your situation would want the recommended course of action and only a small proportion would not	The majority 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	Recognise that different choices will be appropriate for different patients and that you must make greater effort with helping each patient to arrive at a management decision consistent with his or her values and preferences
		Decision aids and shared decision making are particularly useful
Policy makers and developers of quality indicators	The recommendation can be adopted as a policy in most situations	Policy making will require substantial debate and involvement of many stakeholders

* Strong recommendations based on high quality evidence will apply to most patients for whom these recommendations are made, but they may not apply to all patients in all conditions; no recommendation can take into account all of the often-compelling unique features of individual patients and clinical circumstances.

ISSN: 1748-5908