Table 3– Implications of the strength of a recommendation for different users
PerspectiveStrong recommendationConditional recommendation
For patientsMost individuals in this situation would want the recommended course of action and only a small proportion would not. Formal decision aids are not likely to be needed to help individuals make decisions consistent with their values and preferencesThe majority of individuals in this situation would want the suggested course of action, but many would not
For cliniciansMost individuals should receive the intervention. Adherence to this recommendation according to the guidelines could be used as a quality criterion or performance indicatorIt should be recognised that different choices will be appropriate for individual patients, and that patients must be helped to arrive at a management decision consistent with their values and preferences. Decision aids may be useful in helping individuals to make decisions consistent with their values and preferences
For policy makersThe recommendation can be adapted as policy in most situationsPolicy making will require substantial debate and the involvement of various stakeholders