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Article
Strength of Recommendation Taxonomy (SORT): A Patient-Centered Approach to Grading Evidence in the Medical Literature
Journal of the American Board of Family Medicine
  • Mark H. Ebell
  • Jay Siwek
  • Barry D. Weiss
  • Steven H. Woolf
  • Jeffrey Susman
  • Bernard Ewigman
  • Marjorie A. Bowman, Wright State University
Document Type
Article
Publication Date
1-1-2004
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.

Comments

Reprinted in several other journals. Also used formally by the Journal of Evidence-Based Dental Practice [2013;13(2)].

DOI
10.3122/jabfm.17.1.59
Citation Information
Mark H. Ebell, Jay Siwek, Barry D. Weiss, Steven H. Woolf, et al.. "Strength of Recommendation Taxonomy (SORT): A Patient-Centered Approach to Grading Evidence in the Medical Literature" Journal of the American Board of Family Medicine Vol. 17 Iss. 1 (2004) p. 59 - 67 ISSN: 1557-2625
Available at: http://works.bepress.com/marjorie-bowman/124/