Users' Guides to the Medical Literature:  VIII. How to Use Clinical Practice Guidelines B. What Are the Recommendations and Will They Help You in Caring for Your Patients?

Mark C. Wilson, MD, MPH; Robert S. A. Hayward, MD, MPH; Sean R. Tunis, MD, MSc; Eric B. Bass, MD, MPH; Gordon Guyatt, MD, MSc; Deborah Cook, MD, MSc; Brian Haynes, MD, MSc, PhD; Roman Jaeschke, MD, MSc; Andreas Laupacis, MD, MSc; Virginia Moyer, MD, MPH; David Naylor, MD, DPhil; John Philbrick, MD; Scott Richardson, MD; David Sackett, MD, MSc; Stephen Walter, PhD
JAMA. 1995;274(20):1630-1632. doi:10.1001/jama.1995.03530200066040.
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CLINICAL SCENARIO  At the conclusion of our first article on practice guidelines1 in this series, we left you examining the full text of a practice guideline2 that could help you marshal a convincing response to a colleague who disagrees with your approach to hormone replacement therapy (HRT) in postmenopausal women. Later that day, chatting with another colleague, you mention the disagreement. He shrugs, and avows, "It's entirely a matter of personal preference, the evidence doesn't support either of you." You return to the guideline, looking for how particular recommendations may be justified and adapted to your patient's circumstances.

WHAT ARE THE RECOMMENDATIONS?  Are Practical, Clinically Important, Recommendations Made?To be useful, recommendations should give practical, unambiguous advice about a specific health problem. For guidelines about managing health conditions, you should determine if the intent is to prevent, screen for, diagnose, treat, or palliate the disorder. For guidelines about


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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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