Intended for healthcare professionals

Rapid response to:

Education And Debate

A new system for grading recommendations in evidence based guidelines

BMJ 2001; 323 doi: (Published 11 August 2001) Cite this as: BMJ 2001;323:334

Rapid Response:

grade of recommendation

to whom it may concern:

this is your text and the corresponding reference:

Until recently, the system for grading guideline recommendations was
based on the work of the US Agency for Healthcare Research and Quality
(formerly the Agency for Health Care Policy and Research). 1

1 United States Department of Health and Human Services. Agency for
Health Care Policy and Research. Acute pain management: operative or
medical procedures and trauma. Rockville, MD: AHCPR, 1993:107. (Clinical
practice guideline No 1, AHCPR publication No 92-0023.)

this is the reference from

Acute Pain Management: Operative or Medical Procedures and Trauma
Clinical Practice Guideline No. 1.
AHCPR Publication No. 92-0032: February 1992

the publication number and the year are different from your citation

major question:
what is the original first publication where the ahcpr "grades of
recommendation" are reported?
the above mentioned publication, that is cited in your article does report
the "levels of evidence" in appendix b, however, it does not report the
"grades of recommendation" in this guideline.

thank you in advance

sincerely yours

frank peinemann

Competing interests:
None declared

Competing interests: No competing interests

18 February 2004
frank peinemann
medical doctor
duesseldorf, nrw 40474; germany