Recommendation
A recommendation is a formal statement advising a specific course of action in clinical practice, policy, or research, based on an appraisal of the available evidence, benefits and harms, and contextual factors such as feasibility and patient values.
Characteristics
- Informed by systematic review of the evidence
- Weighs benefits vs. risks
- Considers quality of evidence, patient preferences, and resource implications
- Typically issued by expert panels, guideline committees, or health organizations
Types
- Strong recommendation: Benefits clearly outweigh risks (or vice versa); applicable to most patients in most settings
- Conditional (weak) recommendation: Balance of benefits and harms is uncertain, or evidence is low quality; may vary depending on context or values
Example (Clinical)
- “We strongly recommend offering cognitive behavioral therapy (CBT) to patients with chronic tinnitus-related distress.”
- “We conditionally recommend using nortriptyline–topiramate in patients with refractory tinnitus, based on limited evidence.”
Grading Systems
- GRADE (Grading of Recommendations, Assessment, Development and Evaluation)
- Grades strength of recommendation (strong/conditional) and quality of evidence (high/moderate/low/very low)
Why It Matters
- Guides clinical decision-making
- Promotes standardization and quality of care
- Supports shared decision-making with patients
- Ensures that actions are evidence-informed and ethically justified