Cited by 980Clinical practice guidelines implementationMeta-analysis and systematic reviewsHealth Sciences Research and Education

Users' Guides to the Medical Literature: IX. A Method for Grading Health Care Recommendations

Guyatt, Gordon H.·1995·JAMA

Abstract

THE ULTIMATE PURPOSE of applied health research is to improve health care. Summarizing the literature to adduce recommendations for clinical practice is an important part of the process. Recently, the health sciences community has reduced the bias and imprecision of traditional literature summaries and their associated recommendations through the development of rigorous criteria for both literature overviews1-3and practice guidelines.4,5Even when recommendations come from such rigorous approaches, however, it is important to differentiate between those based on weak vs strong evidence. Recommendations based on inadequate evidence often require reversal when sufficient data become available,6while timely implementation of recommendations based on strong evidence can save lives.6In this article, we suggest an approach to classifying strength of recommendations. We direct our discussion primarily at clinicians who make treatment recommendations that they hope their colleagues will follow. However, we believe that any clinician who attends to

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Crossref · 10.1001/jama.1995.03530220066035

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39 of 39 references verified0 citation errors · 0 not checkable

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Authors
Guyatt, G. H.
Corresponding author
Guyatt, Gordon H.
Venue
JAMA
Published
1995-12-13
Volume
274
Issue
22
Pages
1800
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
OpenAlex
W2168226052
Cited by
846
References
39
Citations by year
2026: 16 · 2025: 16 · 2024: 15 · 2023: 24 · 2022: 21 · 2021: 18 · 2020: 57 · 2019: 31 · 2018: 24 · 2017: 27 · 2016: 23 · 2015: 35 · 2014: 30 · 2013: 33 · 2012: 23
FWCI
28.74
Type
journal article
Language
en
Open access
closed
Locations
JAMA (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
  • Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
  • Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
Keywords
strength of recommendation, evidence-based medicine, clinical guidelines, guideline implementation, classification of evidence, clinical decision-making

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