Abstract

The Institute of Medicine in its report “Clinical Practice Guidelines we can trust” defined standards for clinical practice guidelines. However, many guidelines continue to rely on expert opinion and lack a formal framework for moving from evidence to recommendations. These guidelines may or may not be labeled as “consensus statements” and do not meet contemporary standards for guideline documents we would refer to as “evidence-based”. Therefore, the Grading of Recommendations Assessment, Development and Evaluation working group developed a novel, rigorous and transparent approach to grading certainty (quality) of evidence. In addition, it created a system for “moving from evidence to decisions”, for example for the development of evidence-based guidelines. In this article, we aim to introduce this approach to appraising the certainty of relevant evidence and estimate the benefits and detriments of health care interventions within the larger context of evidence-based medicine.

• Keywords: Evidence-based medicine; Guideline