Table 4.
Interpretation of strong and conditional recommendations
| Implications for | Strong recommendation | Conditional recommendation |
|---|---|---|
| Patients | Most individuals in this situation would want the recommended course of action, and only a small proportion would not | The majority of individuals in this situation would want the suggested course of action, but many would not; decision aids may be useful in helping patients to make decisions consistent with their individual risks, values, and preferences |
| Clinicians | Most individuals should follow the recommended course of action; formal decision aids are not likely to be needed to help individual patients make decisions consistent with their values and preferences | Recognize that different choices will be appropriate for individual patients and that you must help each patient arrive at a management decision consistent with the patient’s values and preferences; decision aids may be useful in helping individuals to make decisions consistent with their individual risks, values, and preferences |
| Policy-makers | The recommendation can be adopted as policy in most situations; adherence to this recommendation according to the guideline could be used as a quality criterion or performance indicator | Policy-making will require substantial debate and involvement of various stakeholders; performance measures should assess whether decision-making is appropriate |
| Researchers | The recommendation is supported by credible research or other convincing judgments that make additional research unlikely to alter the recommendation; on occasion, a strong recommendation is based on low or very low certainty in the evidence; in such instances, further research may provide important information that alters the recommendations | The recommendation is likely to be strengthened (for future updates or adaptation) by additional research; an evaluation of the conditions and criteria (and the related judgments, research evidence, and additional considerations) that determined the conditional (rather than strong) recommendation will help identify possible research gaps |