Registered Nurses' Association of Ontario

Levels of Evidence

Strong Recommendation

A strong recommendation reflects the expert panel’s confidence that the desirable effects of an intervention outweigh its undesirable effects (strong recommendation for an intervention) or that the undesirable effects of an intervention outweigh its desirable effects (strong recommendation against an intervention). A strong recommendation implies that the majority of persons will be best served by the recommended action.

Conditional Recommendation

A conditional recommendation reflects the expert panel’s confidence that the desirable effects probably outweigh the undesirable effects (conditional recommendation for an intervention) or undesirable effects probably outweigh desirable effects (conditional recommendation against an intervention), but some uncertainty exists”. A conditional recommendation implies that not all persons will be best served by the recommended action: “there is a need for more careful consideration of personal circumstances, preferences, and values”.

STRONG RECOMMENDATION

 

CONDITIONAL RECOMMENDATION

  • Benefits outweigh harms of a practice that is recommended

 

  • Benefits probably outweigh harms of a practice that is recommended 
  • Harms outweigh benefits of a practice that is not recommended

 

  • Harms probably outweigh benefits of a practice that is not recommended
  • Most persons will benefit from the recommended practice
  • Not everyone will benefit from the recommended practice. There is a need for more careful consideration of:  a) how much persons value the outcomes of a recommended practice and b) potential impact on health equity (if applicable)

 

  • There is good quality evidence (consider certainty and/or confidence in evidence)
  • There is low quality evidence and more research is needed for the area of focus (consider certainty and/or confidence in evidence)

 

 

Older Adults
A Proactive Approach to Bowel & Bladder Management in Adults
Practice Recommendations