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Standard Description
Use systematic reviews. CPG developers should use systematic reviews that meet
IOM’s Standards for Systematic Reviews of Comparative
Effectiveness Research.
Establish evidence
foundations and rate strength
of recommendations.
Rating has specified criteria for strength of
recommendations.
Articulate recommendations. Recommendations should follow a standard format and
be worded so that compliance can be evaluated.
Include external reviewers. External reviews should represent all relevant
stakeholders, and their identity should be kept
confidential. A draft of the CPG should be available to the
public at the external review stage or directly afterward.
Update guidelines. CPGs should be updated when new evidence suggests
the need, and the CPG publication date, date of
systematic evidence review, and proposed date for future
review should be documented.
Literature Reviews (Level V Evidence)
Literature review is a broad term that generally refers to a summary of published
literature without systematic appraisal of evidence quality or strength. Tradition-
al literature reviews are not confined to summaries of scientific literature; they
can also present a narrative description of information from nonscientific litera-
ture, including reports of organizational experience and opinions of experts. Such
reviews possess some of the desired attributes of a systematic review, but not the
same standardized approach, appraisal, and critical review of the studies. For ex-
ample, an author of a narrative review of research studies related to a particular
question may describe comprehensive, even replicable, literature search strategies
but neglect to appraise the quality of the studies discussed. Literature reviews
also vary in completeness and often lack the intent of summarizing all available
evidence on a topic (Grant & Booth, 2009).
