Levels of Evidence, GRADE & Guidelines

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Evidence grading: GRADE (high→very low; downgraded by risk of bias, inconsistency, indirectness, imprecision, publication bias; upgraded by large effect, dose-response). How NICE develops guidance. Strength of recommendation vs quality of evidence (distinct). NICE/SIGN/CKS in UK practice. Guidelines vs guidance vs protocols. Exam tip: a strong recommendation can rest on low-quality evidence and vice versa.

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