Challenges in Developing Recommendations Based on Low-Quality Evidence in Thyroid Guidelines.

Clinical practice guidelines (CPGs) provide guidance informed by evidence and clinical experience, with the ultimate intention of improving health outcomes. The ACP approach, which was originally developed for use in ACP guidelines and shares some core concepts with GRADE, has fewer categories of quality of evidence and fewer dimensions for consideration in formulating the strength of a recommendation than the currently used version of GRADE ([2]). The distinction in use of the original ACP system and GRADE may be a source of confusion, as authors from the same group have recently I incorrectly i reported that the five ATA guidelines discussed above, utilized GRADE ([25]). It may be informative to reflect in greater detail on the experiences of CPG panels in applying the GRADE framework, including the recent experience in the ATA hyperthyroidism CPG Chair (D.S.R.) ([23]). [Extracted from the article]