RT Book, Section
A1 Neumann, Ignacio
A1 Akl, Elie A.
A1 Vandvik, Per Olav
A1 Alonso-Coello, Pablo
A1 Santesso, Nancy
A1 Murad, M. Hassan
A1 Spencer, Frederick
A1 Schünemann, Holger J.
A1 Guyatt, Gordon
A2 Guyatt, Gordon
A2 Rennie, Drummond
A2 Meade, Maureen O.
A2 Cook, Deborah J.
SR Print(0)
ID 1183878256
T1 Assessing the Strength of Recommendations: The GRADE Approach
T2 Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice, 3rd ed
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-179071-0
LK jamaevidence.mhmedical.com/content.aspx?aid=1183878256
RD 2024/04/19
AB CLINICAL  SCENARIOYou  are  a  primary  care  practitioner  considering  the  possibility  of  the  use  of  aspirin  for  primary  prevention  of  serious  cardiovascular  events  and  cancer  in  a  60-year-old  man.  He  has  hypertension,  adequately  controlled  with  thiazides,  but  he  is  otherwise  healthy;  he  does  not  have  diabetes  or  dyslipidemia,  does  not  smoke,  and  has  no  family  history  of  heart  disease.To  inform  your  decision,  you  search  first  for  an  evidence-based  recommendation  and  find  the  following:  “In  many  adults,  the  benefits  of  aspirin  exceed  the  risks  (principally  bleeding).  For  individuals  50  years  or  older  without  excess  bleeding  risk,  we  suggest  low-dose  daily  aspirin  (75-100  mg)  (weak  recommendation  based  on  moderate  confidence  in  effect  estimates).”1After  reading  the  corresponding  Users'  Guide  (see  Chapter  26,  How  to  Use  a  Patient  Management  Recommendation:  Clinical  Practice  Guidelines  and  Decision  Analyses),  you  know  that  weak  recommendations  reflect  the  judgment  of  a  specific  group  (eg,  a  guideline  panel)  that  an  individualized  decision  is  necessary.  You  are  curious,  however,  about  the  rationale  for  a  weak  recommendation  for  aspirin  use  and  decide  that  this  is  a  good  opportunity  to  understand  more  about  the  GRADE  (Grading  of  Recommendations  Assessment,  Development  and  Evaluation)  approach  to  move  from  evidence  to  recommendations.