Strength of Recommendation Taxonomy (SORT)

A Patient-Centered Approach to Grading Evidence in the Medical Literature

Mark H. Ebell, Jay Siwek, Barry D. Weiss, Steven H. Woolf, Jeffrey Susman, Bernard Ewigman, Marjorie Bowman

Research output: Contribution to journalReview article

500 Citations (Scopus)

Abstract

A large number of taxonomies are used to rate the quality of an individual study and the strength of a recommendation based on a body of evidence. We have developed a new grading scale that will be used by several family medicine and primary care journals (required or optional), with the goal of allowing readers to learn one taxonomy that will apply to many sources of evidence. Our scale is called the Strength of Recommendation Taxonomy. It addresses the quality, quantity, and consistency of evidence and allows authors to rate individual studies or bodies of evidence. The taxonomy is built around the information mastery framework, which emphasizes the use of patient-oriented outcomes that measure changes in morbidity or mortality. An A-level recommendation is based on consistent and good-quality patient-oriented evidence; a B-level recommendation is based on inconsistent or limited-quality patient-oriented evidence; and a C-level recommendation is based on consensus, usual practice, opinion, disease-oriented evidence, or case series for studies of diagnosis, treatment, prevention, or screening. Levels of evidence from 1 to 3 for individual studies also are defined. We hope that consistent use of this taxonomy will improve the ability of authors and readers to communicate about the translation of research into practice.

Original languageEnglish (US)
Pages (from-to)548-556
Number of pages9
JournalAmerican family physician
Volume69
Issue number3
StatePublished - Feb 1 2004

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Aptitude
Primary Health Care
Consensus
Medicine
Outcome Assessment (Health Care)
Morbidity
Mortality
Research
Therapeutics

ASJC Scopus subject areas

  • Family Practice

Cite this

Ebell, M. H., Siwek, J., Weiss, B. D., Woolf, S. H., Susman, J., Ewigman, B., & Bowman, M. (2004). Strength of Recommendation Taxonomy (SORT): A Patient-Centered Approach to Grading Evidence in the Medical Literature. American family physician, 69(3), 548-556.

Strength of Recommendation Taxonomy (SORT) : A Patient-Centered Approach to Grading Evidence in the Medical Literature. / Ebell, Mark H.; Siwek, Jay; Weiss, Barry D.; Woolf, Steven H.; Susman, Jeffrey; Ewigman, Bernard; Bowman, Marjorie.

In: American family physician, Vol. 69, No. 3, 01.02.2004, p. 548-556.

Research output: Contribution to journalReview article

Ebell, MH, Siwek, J, Weiss, BD, Woolf, SH, Susman, J, Ewigman, B & Bowman, M 2004, 'Strength of Recommendation Taxonomy (SORT): A Patient-Centered Approach to Grading Evidence in the Medical Literature', American family physician, vol. 69, no. 3, pp. 548-556.
Ebell MH, Siwek J, Weiss BD, Woolf SH, Susman J, Ewigman B et al. Strength of Recommendation Taxonomy (SORT): A Patient-Centered Approach to Grading Evidence in the Medical Literature. American family physician. 2004 Feb 1;69(3):548-556.
Ebell, Mark H. ; Siwek, Jay ; Weiss, Barry D. ; Woolf, Steven H. ; Susman, Jeffrey ; Ewigman, Bernard ; Bowman, Marjorie. / Strength of Recommendation Taxonomy (SORT) : A Patient-Centered Approach to Grading Evidence in the Medical Literature. In: American family physician. 2004 ; Vol. 69, No. 3. pp. 548-556.
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