← Guidelines

Reading a recommendation critically

Three questions worth asking of any guideline statement:

• What is the evidence level? Level I and Level III sit in the same document and often in the same sentence structure, but they are not the same kind of claim.
• Who was in the trials? Exclusion criteria decide who the recommendation actually applies to — and the patient in front of you may have been excluded.
• What was the endpoint? A treatment that improves a number on a monitor has not been shown to improve the outcome that matters unless that outcome was measured.