In Reply In highlighting the potential misuse of practice guidelines in litigation, Mr Kels and Dr Kels draw attention to one of the many unintended consequences of intermediate-grade recommendations; that is, that the authority of a professional society’s imprimatur and the appearance of quantitation inherent in an alphanumeric rating system may convey the impression of an action that is thoroughly evidence-based and ought to be performed, despite any number of layers of equivocation that might be deployed as a hedge against that impression.
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