Table 2.

Implications of Strong versus Conditional Recommendations

Strength of Recommendation
Stakeholder	Strong	Conditional
Patients	Nearly all individuals in this situation would want the recommended course of action; only a small proportion would not	The majority of individuals in this situation would want the suggested course of action, but many would not
Clinicians	Most patients should receive the recommended course of action; adherence to this recommendation could be used as a quality criterion or performance indicator	Different choices will be appropriate for different patients; the clinician must help patients arrive at management decisions consistent with their preferences and values; clinicians should expect to spend more time with patients when working toward a decision
Policy makers	The recommendation can be adapted as policy in most situations; quality-improvement initiatives could use adherence to this recommendation as a performance indicator	Policy making will require substantial debate and involvement of many stakeholders; policies may also vary between regions and health systems