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Comment & Response
May 16, 2017

Legal Ramifications of Ambiguous Clinical Guidelines—Reply

Author Affiliations
  • 1Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
  • 2Linguistics Program, Dartmouth College, Hanover, New Hamphsire
JAMA. 2017;317(19):2020-2021. doi:10.1001/jama.2017.4505

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.