Table 1.

Interpretation of the American College of Physicians' Guideline Grading System (for Therapeutic Interventions)

Recommendation	Clarity of risk/benefit	Implications
Strong recommendation	Benefits clearly outweigh harms and burdens, or vice versa.	Patients: Most would want course of action; a person should request discussion if an intervention is not offered.
		Clinicians: Most patients should receive the recommended course of action.
		Policymakers: The recommendation can be adopted as policy in most circumstances.
Weak recommendation	Benefits closely balanced with harms and burdens.	Patients: Many would want course of action, but some may not; the decision may depend on individual circumstances.
		Clinicians: Different choices will be appropriate for different patients; the management decision should be consistent with patients' preferences and circumstances.
		Policymakers: Policymaking will require careful consideration and stakeholder input.
No recommendation	Balance of benefits and risks cannot be determined.	Decisions based on evidence cannot be made.