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Indirect versus Direct Evidence in U.S. Preventive Services Task Force Recommendations
- Ned Calonge, MD, MPH;
- Diana B. Petitti, MD, MPH; and
- Mary B. Barton, MD, MPP
- From the U.S. Preventive Services Task Force, Rockville, MD 20850.
IN RESPONSE:
We appreciate Dr. Hahn's thoughtful consideration of the potential distinctions between and within USPSTF recommendation grade letters and the role of certainty in arriving at the recommendation grade.
His suggestion that the USPSTF never assign any grade higher than B to a recommendation based on the chain-of-evidence approach (in fact, his proposal would create a new B-minus category for any positive recommendation made on the basis of indirect evidence) implies that only evidence from randomized trials merits a judgment that “certainty of net benefit is …
