BMJ  2004;328:1490 (19 June), doi:10.1136/bmj.328.7454.1490

Education and debate

Grading quality of evidence and strength of recommendations

Clinical guidelines are only as good as the evidence and judgments they are based on. The GRADE approach aims to make it easier for users to assess the judgments behind recommendations

Users of clinical practice guidelines and other recommendations need to know how much confidence they can place in the recommendations. Systematic and explicit methods of making judgments can reduce errors and improve communication. We have developed a system for grading the quality of evidence and the strength of recommendations that can be applied across a wide range of interventions and contexts. In this article we present a summary of our approach from the perspective of a guideline user. Judgments about the strength of a recommendation require consideration of the balance between benefits and harms, the quality of the evidence, translation of the evidence into specific circumstances, and the certainty of the baseline risk. It is also important to consider costs (resource utilisation) before making a recommendation. Inconsistencies among systems for grading the quality of evidence and the strength of recommendations reduce their potential to facilitate critical appraisal and improve communication of these judgments. Our system for guiding these complex judgments balances the need for simplicity with the need for full and transparent consideration of all important issues.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Related Articles

Should we use large scale healthcare interventions without clear evidence that benefits outweigh costs and harms? No

C Seth Landefeld, Kaveh G Shojania, and Andrew D Auerbach
BMJ 2008 336: 1277. [Extract] [Full Text] [PDF]

Grading quality of evidence and strength of recommendations for diagnostic tests and strategies

Holger J Schünemann, Andrew D Oxman, Jan Brozek, Paul Glasziou, Roman Jaeschke, Gunn E Vist, John W Williams, Jr, Regina Kunz, Jonathan Craig, Victor M Montori, Patrick Bossuyt, Gordon H Guyatt for the GRADE Working Group
BMJ 2008 336: 1106-1110. [Extract] [Full Text] [PDF]

What is "quality of evidence" and why is it important to clinicians?

Gordon H Guyatt, Andrew D Oxman, Regina Kunz, Gunn E Vist, Yngve Falck-Ytter, Holger J Schünemann for the GRADE Working Group
BMJ 2008 336: 995-998. [Extract] [Full Text] [PDF]

Direct to consumer advertising of drugs in Europe

Nicola Magrini and Maria Font
BMJ 2007 335: 526. [Extract] [Full Text] [PDF]

When are randomised trials unnecessary? Picking signal from noise

Paul Glasziou, Iain Chalmers, Michael Rawlins, and Peter McCulloch
BMJ 2007 334: 349-351. [Abstract] [Full Text] [PDF]

A practical approach to timing cord clamping in resource poor settings

Patrick F van Rheenen and Bernard J Brabin
BMJ 2006 333: 954-958. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

• Tyler, L. S., Cole, S. W., May, J. R., Millares, M., Valentino, M. A., Vermeulen, L. C. Jr., Wilson, A. L., DEVELOPED BY AN ASHP EXPERT PANEL ON FORMULARY MAN, (2008). ASHP Guidelines on the Pharmacy and Therapeutics Committee and the Formulary System. Am J Health Syst Pharm 65: 1272-1283 [Full text]  
• Lanzkron, S., Strouse, J. J., Wilson, R., Beach, M. C., Haywood, C., Park, H., Witkop, C., Bass, E. B., Segal, J. B. (2008). Systematic Review: Hydroxyurea for the Treatment of Adults with Sickle Cell Disease. ANN INTERN MED 148: 939-955 [Abstract] [Full text]  
• Landefeld, C S., Shojania, K. G, Auerbach, A. D (2008). Should we use large scale healthcare interventions without clear evidence that benefits outweigh costs and harms? No. BMJ 336: 1277-1277 [Full text]  
• Strech, D, Synofzik, M, Marckmann, G (2008). Systematic reviews of empirical bioethics. J. Med. Ethics 34: 472-477 [Abstract] [Full text]  
• Schunemann, H. J., Cook, D., Guyatt, G. (2008). Methodology for Antithrombotic and Thrombolytic Therapy Guideline Development: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 133: 113S-122S [Abstract] [Full text]  
• Guyatt, G. H., Cook, D. J., Jaeschke, R., Pauker, S. G., Schunemann, H. J. (2008). Grades of Recommendation for Antithrombotic Agents: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 133: 123S-131S [Abstract] [Full text]  
• Whitlock, E. P., Lin, J. S., Chou, R., Shekelle, P., Robinson, K. A. (2008). Using Existing Systematic Reviews in Complex Systematic Reviews. ANN INTERN MED 148: 776-782 [Abstract] [Full text]  
• Chou, R., Shekelle, P., Qaseem, A., Owens, D. K. (2008). Overviews and Systematic Reviews on Low Back Pain. ANN INTERN MED 148: 791-792 [Full text]  
• Schunemann, H. J, Oxman, A. D, Brozek, J., Glasziou, P., Jaeschke, R., Vist, G. E, Williams, J. W Jr, Kunz, R., Craig, J., Montori, V. M, Bossuyt, P., Guyatt, G. H, for the GRADE Working Group, (2008). Grading quality of evidence and strength of recommendations for diagnostic tests and strategies. BMJ 336: 1106-1110 [Full text]  
• Liu, H., Paige, N. M., Goldzweig, C. L., Wong, E., Zhou, A., Suttorp, M. J., Munjas, B., Orwoll, E., Shekelle, P. (2008). Screening for Osteoporosis in Men: A Systematic Review for an American College of Physicians Guideline. ANN INTERN MED 148: 685-701 [Abstract] [Full text]  
• Guyatt, G. H, Oxman, A. D, Kunz, R., Vist, G. E, Falck-Ytter, Y., Schunemann, H. J, for the GRADE Working Group, (2008). What is "quality of evidence" and why is it important to clinicians?. BMJ 336: 995-998 [Full text]  
• Tobin, M. J. (2008). Counterpoint: Evidence-Based Medicine Lacks a Sound Scientific Base. Chest 133: 1071-1074 [Full text]  
• Guyatt, G. H., Karanicolas, P. J., Kunz, R. (2008). Rebuttal From Dr. Guyatt et al. Chest 133: 1074-1075 [Full text]  
• Tobin, M. J. (2008). Rebuttal From Dr. Tobin. Chest 133: 1076-1077 [Full text]  
• Beris, P., Munoz, M., Garcia-Erce, J. A., Thomas, D., Maniatis, A., Van der Linden, P. (2008). Perioperative anaemia management: consensus statement on the role of intravenous iron. Br J Anaesth 100: 599-604 [Abstract] [Full text]  
• Scascighini, L., Toma, V., Dober-Spielmann, S., Sprott, H. (2008). Multidisciplinary treatment for chronic pain: a systematic review of interventions and outcomes. Rheumatology (Oxford) 47: 670-678 [Abstract] [Full text]  
• Hamashima, C., Saito, H., Nakayama, T., Nakayama, T., Sobue, T. (2008). The Standardized Development Method of the Japanese Guidelines for Cancer Screening. Jpn J Clin Oncol 38: 288-295 [Abstract] [Full text]  
• Martin, K. A., Chang, R. J., Ehrmann, D. A., Ibanez, L., Lobo, R. A., Rosenfield, R. L., Shapiro, J., Montori, V. M., Swiglo, B. A. (2008). Evaluation and Treatment of Hirsutism in Premenopausal Women: An Endocrine Society Clinical Practice Guideline. J. Clin. Endocrinol. Metab. 93: 1105-1120 [Abstract] [Full text]  
• Brouwers, M. C., Somerfield, M. R., Browman, G. P. (2008). A for Effort: Learning From the Application of the GRADE Approach to Cancer Guideline Development. JCO 26: 1025-1026 [Full text]  
• De Palma, R., Liberati, A., Ciccone, G., Bandieri, E., Belfiglio, M., Ceccarelli, M., Leoni, M., Longo, G., Magrini, N., Marangolo, M., Roila, F. (2008). Developing Clinical Recommendations for Breast, Colorectal, and Lung Cancer Adjuvant Treatments Using the GRADE System: A Study From the Programma Ricerca e Innovazione Emilia Romagna Oncology Research Group. JCO 26: 1033-1039 [Abstract] [Full text]  
• Fletcher, J. W., Djulbegovic, B., Soares, H. P., Siegel, B. A., Lowe, V. J., Lyman, G. H., Coleman, R. E., Wahl, R., Paschold, J. C., Avril, N., Einhorn, L. H., Suh, W. W., Samson, D., Delbeke, D., Gorman, M., Shields, A. F. (2008). Recommendations on the Use of 18F-FDG PET in Oncology. JNM 49: 480-508 [Abstract] [Full text]  
• Ioannidis, J. P., Boffetta, P., Little, J., O'Brien, T. R, Uitterlinden, A. G, Vineis, P., Balding, D. J, Chokkalingam, A., Dolan, S. M, Flanders, W D., Higgins, J. P., McCarthy, M. I, McDermott, D. H, Page, G. P, Rebbeck, T. R, Seminara, D., Khoury, M. J (2008). Assessment of cumulative evidence on genetic associations: interim guidelines. Int J Epidemiol 37: 120-132 [Abstract] [Full text]  
• Lorenz, K. A., Lynn, J., Dy, S. M., Shugarman, L. R., Wilkinson, A., Mularski, R. A., Morton, S. C., Hughes, R. G., Hilton, L. K., Maglione, M., Rhodes, S. L., Rolon, C., Sun, V. C., Shekelle, P. G. (2008). Evidence for Improving Palliative Care at the End of Life: A Systematic Review. ANN INTERN MED 148: 147-159 [Abstract] [Full text]  
• Browman, G. P., Manns, B., Hagen, N., Chambers, C. R., Simon, A., Sinclair, S. (2008). 6-STEPPPs: A Modular Tool to Facilitate Clinician Participation in Fair Decisions for Funding New Cancer Drugs. J Oncol Pract 4: 2-7 [Abstract] [Full text]  
• Dartnell, J., Hemming, M., Collier, J., Ollenschlaeger, G. (2008). Putting evidence into context: some advice for guideline writers. Evid. Based Nurs. 11: 6-8 [Full text]  
• Matchar, D. B., McCrory, D. C., Orlando, L. A., Patel, M. R., Patel, U. D., Patwardhan, M. B., Powers, B., Samsa, G. P., Gray, R. N. (2008). Systematic Review: Comparative Effectiveness of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers for Treating Essential Hypertension. ANN INTERN MED 148: 16-29 [Abstract] [Full text]  
• Sodeck, G., Domanovits, H., Schillinger, M., Ehrlich, M. P., Endler, G., Herkner, H., Laggner, A. (2007). D-dimer in ruling out acute aortic dissection: a systematic review and prospective cohort study. Eur Heart J 28: 3067-3075 [Abstract] [Full text]  
• Higgins, B. G (2007). The modern way of developing clinical guidelines. Thorax 62: 1022-1024 [Full text]  
• Spiller, R, Aziz, Q, Creed, F, Emmanuel, A, Houghton, L, Hungin, P, Jones, R, Kumar, D, Rubin, G, Trudgill, N, Whorwell, P (2007). Guidelines on the irritable bowel syndrome: mechanisms and practical management. Gut 56: 1770-1798 [Abstract] [Full text]  
• Berry, A. M., Davidson, P. M., Masters, J., Rolls, K. (2007). Systematic Literature Review of Oral Hygiene Practices for Intensive Care Patients Receiving Mechanical Ventilation. Am J Crit Care 16: 552-562 [Abstract] [Full text]  
• Dartnell, J., Hemming, M., Collier, J., Ollenschlaeger, G. (2007). Putting evidence into context: some advice for guideline writers. Evid. Based Med. 12: 130-132 [Full text]  
• Authors/Task Force Members, , Graham, I., Atar, D., Borch-Johnsen, K., Boysen, G., Burell, G., Cifkova, R., Dallongeville, J., De Backer, G., Ebrahim, S., Gjelsvik, B., Herrmann-Lingen, C., Hoes, A., Humphries, S., Knapton, M., Perk, J., Priori, S. G., Pyorala, K., Reiner, Z., Ruilope, L., Sans-Menendez, S., Scholte op Reimer, W., Weissberg, P., Wood, D., Yarnell, J., Zamorano, J. L., Other experts who contributed to parts of the guid, , Walma, E., Fitzgerald, T., Cooney, M. T., Dudina, A., European Society of Cardiology (ESC) Committee for, , Vahanian, A., Camm, J., De Caterina, R., Dean, V., Dickstein, K., Funck-Brentano, C., Filippatos, G., Hellemans, I., Kristensen, S. D., McGregor, K., Sechtem, U., Silber, S., Tendera, M., Widimsky, P., Zamorano, J. L., Document reviewers:, , Hellemans, I., Altiner, A., Bonora, E., Durrington, P. N., Fagard, R., Giampaoli, S., Hemingway, H., Hakansson, J., Kjeldsen, S. E., Larsen, M. L., Mancia, G., Manolis, A. J., Orth-Gomer, K., Pedersen, T., Rayner, M., Ryden, L., Sammut, M., Schneiderman, N., Stalenhoef, A. F., Tokgozoglu, L., Wiklund, O., Zampelas, A. (2007). European guidelines on cardiovascular disease prevention in clinical practice: executive summary: Fourth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (Constituted by representatives of nine societies and by invited experts). Eur Heart J 28: 2375-2414 [Full text]  
• Bolen, S., Feldman, L., Vassy, J., Wilson, L., Yeh, H.-C., Marinopoulos, S., Wiley, C., Selvin, E., Wilson, R., Bass, E. B., Brancati, F. L. (2007). Systematic Review: Comparative Effectiveness and Safety of Oral Medications for Type 2 Diabetes Mellitus. ANN INTERN MED 147: 386-399 [Abstract] [Full text]  
• Magrini, N., Font, M. (2007). Direct to consumer advertising of drugs in Europe. BMJ 335: 526-526 [Full text]  
• Milroy, R. (2007). New American College of Chest Physicians Lung Cancer Guidelines*: An Important Addition to the Lung Cancer Guidelines Armamentarium. Chest 132: 744-746 [Full text]  
• Sinuff, T., Eva, K. W., Meade, M., Dodek, P., Heyland, D., Cook, D. (2007). Clinical practice guidelines in the intensive care unit: a survey of Canadian clinicians' attitudes: [Guide de pratique clinique dans les unites de soins intensifs : un sondage sur les attitudes des cliniciens canadiens]. Canadian J. Anesthesia 54: 728-736 [Abstract] [Full text]  
• Rambout, L. BScPhm, Hopkins, L. MD MSc, Hutton, B. MSc, Fergusson, D. PhD (2007). Prophylactic vaccination against human papillomavirus infection and disease in women: a systematic review of randomized controlled trials. CMAJ 177: 469-479 [Abstract] [Full text]  
• Sundaresan, S., Langer, B., Oliver, T., Schwartz, F., Brouwers, M., Stern, H., Expert Panel on Thoracic Surgical Oncology, (2007). Standards for Thoracic Surgical Oncology in a Single-Payer Healthcare System. Ann. Thorac. Surg. 84: 693-701 [Abstract] [Full text]  
• Barton, M. B., Miller, T., Wolff, T., Petitti, D., LeFevre, M., Sawaya, G., Yawn, B., Guirguis-Blake, J., Calonge, N., Harris, R., for the U.S. Preventive Services Task Force, (2007). How to Read the New Recommendation Statement: Methods Update from the U.S. Preventive Services Task Force. ANN INTERN MED 147: 123-127 [Abstract] [Full text]  
• Poolman, R. W., Abouali, J. A.K., Conter, H. J., Bhandari, M. (2007). Overlapping Systematic Reviews of Anterior Cruciate Ligament Reconstruction Comparing Hamstring Autograft with Bone-Patellar Tendon-Bone Autograft: Why Are They Different?. JBJS 89: 1542-1552 [Abstract] [Full text]  
• Langhorne, P. (2007). Explicit Priority Setting in Clinical Guidelines: The Next Frontier?. Stroke 38: 2037-2037 [Full text]  
• Karanicolas, P. J., Davies, E., Kunz, R., Briel, M., Koka, H. P., Payne, D. M., Smith, S. E., Hsu, H.-P., Lin, P.-W., Bloechle, C., Paquet, K.-J., Guyatt, G. H. (2007). The Pylorus: Take It or Leave It? Systematic Review and Meta-Analysis of Pylorus-Preserving versus Standard Whipple Pancreaticoduodenectomy for Pancreatic or Periampullary Cancer. Ann. Surg. Oncol. 14: 1825-1834 [Abstract] [Full text]  
• Vanholder, R. (2007). Approach for guideline development. Nephrol Dial Transplant 22: ii1-ii4 [Full text]  
• Goldsmith, M. R, Bankhead, C. R, Austoker, J. (2007). Synthesising quantitative and qualitative research in evidence-based patient information. J. Epidemiol. Community Health 61: 262-270 [Abstract] [Full text]  
• Himmelfarb, J., Henrich, W., DuBose, T. (2007). Anemia of Kidney Disease and Clinical Practice Guidelines: Quo Vadis?. CJASN 2: 213-214 [Full text]  
• Boulware, L. E., Marinopoulos, S., Phillips, K. A., Hwang, C. W., Maynor, K., Merenstein, D., Wilson, R. F., Barnes, G. J., Bass, E. B., Powe, N. R., Daumit, G. L. (2007). Systematic Review: The Value of the Periodic Health Evaluation. ANN INTERN MED 146: 289-300 [Abstract] [Full text]  
• Glasziou, P., Chalmers, I., Rawlins, M., McCulloch, P. (2007). When are randomised trials unnecessary? Picking signal from noise. BMJ 334: 349-351 [Abstract] [Full text]  
• Taylor, B. J., Dempster, M., Donnelly, M. (2007). Grading Gems: Appraising the Quality of Research for Social Work and Social Care. Br J Soc Work 37: 335-354 [Abstract] [Full text]  
• Corman, S. L., Skledar, S. J., Culley, C. M. (2007). Evaluation of conflicting literature and application to formulary decisions. Am J Health Syst Pharm 64: 182-185 [Abstract] [Full text]  
• Lyles, C. M., Kay, L. S., Crepaz, N., Herbst, J. H., Passin, W. F., Kim, A. S., Rama, S. M., Thadiparthi, S., DeLuca, J. B., Mullins, M. M., for the Hiv/aids Prevention Research Synthesis Tea, (2007). Best-Evidence Interventions: Findings From a Systematic Review of HIV Behavioral Interventions for US Populations at High Risk, 2000-2004. Am. J. Public Health 97: 133-143 [Abstract] [Full text]  
• Huang, H.-Y. (2006). Customized Diets for Cancer Prevention According to Genetic Polymorphisms: Are We Ready Yet?. JNCI J Natl Cancer Inst 98: 1590-1591 [Full text]  
• van Rheenen, P. F, Brabin, B. J (2006). A practical approach to timing cord clamping in resource poor settings. BMJ 333: 954-958 [Full text]  
• Verkerk, K., Van Veenendaal, H., Severens, J. L., Hendriks, E. J. M., Burgers, J. S. (2006). Considered judgement in evidence-based guideline development. Int J Qual Health Care 18: 365-369 [Abstract] [Full text]  
• Wierman, M. E., Basson, R., Davis, S. R., Khosla, S., Miller, K. K., Rosner, W., Santoro, N. (2006). Androgen Therapy in Women: An Endocrine Society Clinical Practice Guideline. J. Clin. Endocrinol. Metab. 91: 3697-3710 [Abstract] [Full text]  
• Barnett, M. L., Hyman, J. J. (2006). Challenges in interpreting study results: The conflict between appearance and reality. Journal of the American Dental Association 137: 32S-36S [Abstract] [Full text]  
• Huang, H.-Y., Caballero, B., Chang, S., Alberg, A. J., Semba, R. D., Schneyer, C. R., Wilson, R. F., Cheng, T.-Y., Vassy, J., Prokopowicz, G., Barnes, G. J. II, Bass, E. B. (2006). The Efficacy and Safety of Multivitamin and Mineral Supplement Use To Prevent Cancer and Chronic Disease in Adults: A Systematic Review for a National Institutes of Health State-of-the-Science Conference. ANN INTERN MED 145: 372-385 [Abstract] [Full text]  
• Schunemann, H. J., Jaeschke, R., Cook, D. J., Bria, W. F., El-Solh, A. A., Ernst, A., Fahy, B. F., Gould, M. K., Horan, K. L., Krishnan, J. A., Manthous, C. A., Maurer, J. R., McNicholas, W. T., Oxman, A. D., Rubenfeld, G., Turino, G. M., Guyatt, G., on behalf of the ATS Documents Development and Imp, (2006). An Official ATS Statement: Grading the Quality of Evidence and Strength of Recommendations in ATS Guidelines and Recommendations. Am. J. Respir. Crit. Care Med. 174: 605-614 [Full text]  
• Smith, F. G., Tong, J. L, Smith, J. E (2006). Evidence-based medicine. Contin Educ Anaesth Crit Care Pain 6: 148-151 [Full text]  
• Neumann, P. J. (2006). Emerging Lessons From The Drug Effectiveness Review Project. Health Aff (Millwood) 25: W262-W271 [Abstract] [Full text]  
• Bridevaux, I. P., Silaghi, A.-M., Vader, J.-P., Froehlich, F., Gonvers, J.-J., Burnand, B. (2006). Appropriateness of colorectal cancer screening: appraisal of evidence by experts. Int J Qual Health Care 18: 177-182 [Abstract] [Full text]  
• Woolf, S. H. (2006). Weighing the evidence to formulate dietary guidelines.. J. Am. Coll. Nutr. 25: 277S-284S [Abstract] [Full text]  
• Uhlig, K., Balk, E. M., Lau, J., Levey, A. S. (2006). Clinical Practice Guidelines in nephrology--for worse or for better. Nephrol Dial Transplant 21: 1145-1153 [Full text]  
• Vigna-Taglianti, F., Vineis, P., Liberati, A., Faggiano, F. (2006). Quality of systematic reviews used in guidelines for oncology practice. Ann Oncol 17: 691-701 [Abstract] [Full text]  
• Zochling, J, van der Heijde, D, Burgos-Vargas, R, Collantes, E, Davis, J C Jr, Dijkmans, B, Dougados, M, Geher, P, Inman, R D, Khan, M A, Kvien, T K, Leirisalo-Repo, M, Olivieri, I, Pavelka, K, Sieper, J, Stucki, G, Sturrock, R D, van der Linden, S, Wendling, D, Bohm, H, van Royen, B J, Braun, J (2006). ASAS/EULAR recommendations for the management of ankylosing spondylitis. Ann Rheum Dis 65: 442-452 [Abstract] [Full text]  
• Hayden, J. A., Cote, P., Bombardier, C. (2006). Evaluation of the quality of prognosis studies in systematic reviews.. ANN INTERN MED 144: 427-437 [Abstract] [Full text]  
• Chiappelli, F., Prolo, P., Rosenblum, M., Edgerton, M., Cajulis, O. S. (2006). Evidence-Based Research in Complementary and Alternative Medicine II: The Process of Evidence-Based Research.. Evid Based Complement Alternat Med 3: 3-12 [Abstract] [Full text]  
• Wang, S., Moss, J. R., Hiller, J. E. (2006). Applicability and transferability of interventions in evidence-based public health. HEALTH PROMOT INT 21: 76-83 [Abstract] [Full text]  
• Johnson, C. J. (2006). Getting started in evidence-based practice for childhood speech-language disorders.. AJSLP 15: 20-35 [Abstract] [Full text]  
• Guyatt, G., Vist, G., Falck-Ytter, Y., Kunz, R., Magrini, N., Schunemann, H. (2006). An emerging consensus on grading recommendations?. Evid. Based Med. 11: 2-4 [Full text]  
• Kunz, R. (2006). "What's in the Black Box?". Chest 129: 7-10 [Full text]  
• Baumann, M. H., Gutterman, D. D. (2006). American College of Chest Physicians Evidence-Based Guidelines-the Next Generation: Considering Resource Use and Evolution to a Single Grading System. Chest 129: 10-12 [Full text]  
• Guyatt, G., Gutterman, D., Baumann, M. H., Addrizzo-Harris, D., Hylek, E. M., Phillips, B., Raskob, G., Lewis, S. Z., Schunemann, H. (2006). Grading Strength of Recommendations and Quality of Evidence in Clinical Guidelines: Report From an American College of Chest Physicians Task Force. Chest 129: 174-181 [Abstract] [Full text]  
• Glasmacher, A., Prentice, A. (2006). The role of meta-analysis in the evaluation of antifungal prophylaxis: authors' response. J Antimicrob Chemother 57: 152-154 [Full text]  
• Watine, J., Friedberg, B., Nagy, E., Onody, R., Oosterhuis, W., Bunting, P. S., Charet, J.-C., Horvath, A. R. (2006). Conflict between Guideline Methodologic Quality and Recommendation Validity: A Potential Problem for Practitioners. Clin. Chem. 52: 65-72 [Abstract] [Full text]  
• Kiire, C A, Dhillon, B (2006). The aetiology and associations of conjunctival intraepithelial neoplasia. Br. J. Ophthalmol. 90: 109-113 [Abstract] [Full text]  
• Tovey, D., Bognolo, G. (2005). Levels of evidence and the orthopaedic surgeon. J Bone Joint Surg Br 87-B: 1591-1592 [Full text]  
• Schunemann, H. J., Heffner, J. E. (2005). A New ATS Committee: Competing in the Marketplace of Ideas. Am. J. Respir. Cell Mol. Bio. 33: 423-424 [Full text]  
• Schunemann, H. J., Heffner, J. E. (2005). A New ATS Committee: Competing in the Marketplace of Ideas. Proc Am Thorac Soc 2: 249-250 [Full text]  
• Schunemann, H. J., Heffner, J. E. (2005). A New ATS Committee: Competing in the Marketplace of Ideas. Am. J. Respir. Crit. Care Med. 172: 1067-1068 [Full text]  
• Guise, J.-M., Austin, D., Morris, C. D. (2005). Review of Case-Control Studies Related to Breastfeeding and Reduced Risk of Childhood Leukemia. Pediatrics 116: e724-e731 [Abstract] [Full text]  
• Bridges, N., Jarquin-Valdivia, A. A. (2005). Use of the Trendelenburg Position as the Resuscitation Position: To T or Not to T?. Am J Crit Care 14: 364-368 [Abstract] [Full text]  
• Varonen, H., Jousimaa, J., Helin-Salmivaara, A., Kunnamo, I. (2005). Electronic primary care guidelines with links to Cochrane reviews--EBM Guidelines. Fam Pract 22: 465-469 [Abstract] [Full text]  
• Materia, E., Baglio, G. (2005). Health, science, and complexity. J. Epidemiol. Community Health 59: 534-535 [Full text]  
• Atkins, D., Fink, K., Slutsky, J. (2005). Better Information for Better Health Care: The Evidence-based Practice Center Program and the Agency for Healthcare Research and Quality. ANN INTERN MED 142: 1035-1041 [Abstract] [Full text]  
• Chou, R., Helfand, M. (2005). Challenges in Systematic Reviews That Assess Treatment Harms. ANN INTERN MED 142: 1090-1099 [Abstract] [Full text]  
• Patsopoulos, N. A., Analatos, A. A., Ioannidis, J. P. A. (2005). Relative Citation Impact of Various Study Designs in the Health Sciences. JAMA 293: 2362-2366 [Abstract] [Full text]