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

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

Guyatt, Gordon H.·1995·JAMA

DOI 10.1001/jama.1995.03530220066035

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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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Book Reviews: Statistical Methods for Meta-Analysis Larry V. Hedges and Ingram Olkin New York: Academic Press, 1985. xxii + 369 pp
Wasserman, S. S., Hedges, L. V., & Olkin, I. (1988) · Journal of Educational Statistics · doi:10.2307/1164953 · Cited by 10,377
Measurement of health state utilities for economic appraisal
Torrance, G. W. (1986) · Journal of Health Economics · doi:10.1016/0167-6296(86)90020-2 · Cited by 2,220
An Assessment of Clinically Useful Measures of the Consequences of Treatment
Laupacis, A., Sackett, D. L., & Roberts, R. S. (1988) · New England Journal of Medicine · doi:10.1056/nejm198806303182605 · Cited by 1,681
Rules of Evidence and Clinical Recommendations on the Use of Antithrombotic Agents
Sackett, D. L. (1989) · CHEST Journal · doi:10.1378/chest.95.2_supplement.2s · Cited by 1,369
Statistics with Confidence: Confidence Intervals and Statistical Guidelines.
JOLLIFFE, F. R., Gardner, M. J., & Altman, D. G. (1990) · Journal of the Royal Statistical Society Series A (Statistics in Society) · doi:10.2307/2982808 · Cited by 1,319
Meta-Analysis in Clinical Research
L'ABBÉ, K. A., DETSKY, A. S., & O'ROURKE, K. (1987) · Annals of Internal Medicine · doi:10.7326/0003-4819-107-2-224 · Cited by 1,267
Meta-Analyses of Randomized Controlled Trials
Sacks, H. S., Berrier, J., Reitman, D., Ancona-Berk, V. A., & Chalmers, T. C. (1987) · New England Journal of Medicine · doi:10.1056/nejm198702193160806 · Cited by 1,257
Analysis and interpretation of treatment effects in subgroups of patients in randomized clinical trials
Yusuf, S. (1991) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.1991.03470010097038 · Cited by 1,014
Risk Factors for Gastrointestinal Bleeding in Critically Ill Patients
Cook, D. J., Fuller, H. D., Guyatt, G. H., Marshall, J. C., Leasa, D., Hall, R., Winton, T. L., Rutledge, F., Todd, T., Roy, P., et al. (1994) · New England Journal of Medicine · doi:10.1056/nejm199402103300601 · Cited by 1,010
Self-citation
Users' Guides to the Medical Literature
Oxman, A. D. (1994) · JAMA · doi:10.1001/jama.1994.03520170077040 · Cited by 925

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Authors: Guyatt, G. H.
Corresponding author: Guyatt, Gordon H.
ORCID: Guyatt, Gordon H.
Venue: JAMA
Publisher: American Medical Association (AMA)
Published: 1995-12-13
Volume: 274
Issue: 22
Pages: 1800
ISSN: 0002-9955 (ISSN-L)
0098-7484
DOI: 10.1001/jama.1995.03530220066035
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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