TABLE 2.

Implications of clinical guideline recommendations by stakeholder

Stakeholder	Strong recommendation	Conditional recommendation
Patient	The majority of patients would want the recommended course of action in this situation and only a small number would not.	Many patients in this situation would prefer recommendation, but a substantial number may not. This is an opportunity for shared decision-making between the clinician and the patient.
Clinician	Most individuals should receive the course of action that is recommended. There is a low chance that additional formal decision aids are needed to help individuals make decisions consistent with their values and preferences and adherence to this recommendation could be used as a performance indicator or quality criterion.	Different choices will be applicable to different patients and additional factors will need to be considered in addition to the recommendation in order for a patient to make a decision according to their values and preferences. Decision aids may be needed to assist individuals in making their best choice. This is an opportunity for shared decision-making between the clinician and the patient.
Policy-maker	The recommendation can be widely adapted as policy and can be used for performance indicators.	Policy-making will require substantial additional debate and involvement of many and/or additional stakeholders. The likelihood of regional variance is also higher. Performance indicators would need to take into consideration any additional deliberation that has occurred.