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Record W3205507353 · doi:10.1001/jama.2021.15319

How to Interpret and Use a Clinical Practice Guideline or Recommendation

2021· article· en· W3205507353 on OpenAlexaff
Romina Brignardello‐Petersen, Alonso Carrasco‐Labra, Gordon Guyatt

Bibliographic record

VenueJAMA · 2021
Typearticle
Languageen
FieldMedicine
TopicClinical practice guidelines implementation
Canadian institutionsMcMaster UniversityImpact
Fundersnot available
KeywordsGuidelineMedicineMEDLINEProcess (computing)Evidence-based medicineClinical PracticeStatement (logic)Family medicineAlternative medicinePathologyComputer science

Abstract

fetched live from OpenAlex

IMPORTANCE: Clinicians may rely on recommendations from clinical practice guidelines for management of patients. OBSERVATIONS: A clinical practice guideline is a published statement that includes recommendations that are intended to optimize patient care. In the guideline development process, a panel of experts formulates recommendation questions that guide the retrieval of evidence that is used to inform the recommendations. Typically, methods of guideline development, a summary of the supporting evidence, and a justification of the panel's decisions accompany the recommendations. To use such guidelines optimally, clinicians must understand the implications of the recommendations, assess the trustworthiness of the development process, and evaluate the extent to which the recommendations are applicable to patients in their practice settings. Helpful recommendations are clear and actionable, and explicitly specify whether they are strong or weak, are appropriate for all patients, or depend on individual patients' circumstances and values. Rigorous guidelines and recommendations are informed by appropriately conducted, up-to-date systematic reviews that consider outcomes important to patients. Because judgments are involved in the interpretation of the evidence and the process of moving from evidence to recommendations, useful guidelines consider all relevant factors that have a bearing in a clinical decision and are not influenced by conflicts of interest. CONCLUSIONS AND RELEVANCE: In considering a guideline's recommendations, clinicians must decide whether there are important differences between the factors the guideline panel has considered in making recommendations and their own practice setting.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.139
metaresearch head score (Gemma)0.746
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: Not applicable
GenreCandidate signal: Methods · Consensus signal: none
Teacher disagreement score0.139
Threshold uncertainty score0.737

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.1390.746
Meta-epidemiology (narrow)0.0030.003
Meta-epidemiology (broad)0.0080.005
Bibliometrics0.0140.010
Science and technology studies0.0040.009
Scholarly communication0.0230.020
Open science0.0100.007
Research integrity0.0300.028
Insufficient payload (model declined to judge)0.0220.024

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.310
GPT teacher head0.558
Teacher spread0.247 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designNot applicable
Domainnot available
GenreMethods

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations95
Published2021
Admission routes1
Has abstractyes

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