Lessons Learned from Nutrition Guidelines and Evidence-Based Medicine

Clinical practice guidelines help health care providers two ways, through organizing the literature by topical categories and by providing treatment strategies which should theoretically result in optimal patient outcomes. The adoption of the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) classification system has helped standardize the process by which the literature is evaluated and guidelines are reported. The body of scientific data which ultimately drives patient management comes in all forms, however, from expert opinion and clinical experience to prospective randomized trials and meta-analysis. Overreliance on methodology and levels of evidence can lead to spurious results when interpreting the literature. Modifications of the GRADE process and innovations in the manner by which committees evaluate the supportive evidence may improve the value of clinical guidelines to the practitioner in the future.