Can we trust strong recommendations based on low quality evidence?
Bibliographic record
Abstract
A necessary requirement for development of trustworthy guidelines is to respect the relation between the quality (certainty) of evidence and strength of recommendations. Strong recommendations are justified when they are based on high quality evidence, because such recommendations are considered more accurate.1 On the other hand, uncertainty in benefits and harms (that is, low quality evidence) generally leads to weaker recommendations. The failure to recognise this important principle results in a tendency to issue strong recommendations based on low quality evidence (which we call discordant recommendations), often leading to harm. For instance, based on advice from low quality evidence, women have experienced avoidable adverse effects from hormone replacement therapy prescribed for the prevention of cardiovascular disease; and …
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot 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.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.166 | 0.682 |
| Meta-epidemiology (narrow) | 0.003 | 0.003 |
| Meta-epidemiology (broad) | 0.009 | 0.005 |
| Bibliometrics | 0.008 | 0.005 |
| Science and technology studies | 0.003 | 0.010 |
| Scholarly communication | 0.019 | 0.024 |
| Open science | 0.009 | 0.006 |
| Research integrity | 0.039 | 0.055 |
| Insufficient payload (model declined to judge) | 0.012 | 0.012 |
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.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
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".