Table 3 Pros and cons of using the same system for grading evidence and formulating recommendations for a wide range of health care interventions, including clinical and non-clinical interventions
Arguments for having a common approach | Arguments against having a common approach |
|---|---|
• Having less demanding systems for some kinds of questions might result in false positive conclusions. • People with vested interests in particular interventions could choose the system that makes their intervention look best. • People with vested interests in particular evaluation approaches could choose the system that makes their preferred evaluation approach look best. • Having different systems for different types of interventions might be confusing. • It is intellectually honest to recognise the limits of evidence where this is appropriate. • Admitting the limitations of evidence, if this is appropriate, might promote more and better research. | • Having an infeasible system for some kinds of questions might result in false negative conclusions. • False negative conclusions due to inappropriate evaluation requirements may have negative political and health consequences; for example, effective programs that cannot be studied with randomised trials might experience funding cuts. • Interventions that cannot be studied with randomised trials might not be evaluated. • A single system may not discriminate adequately within the range of evidence that is appropriate to consider for clinical and non-clinical interventions. • A system that can adequately address evidence across a wide range of interventions and contexts may be overly complex. |