In Reply We agree that the ACP guidance statement has ignited critical dialogue and attention to an important issue. Our rating for “establishing evidence foundations” was largely based on the lack of justification for including only the 5 long-term randomized trials referenced in existing guidelines.1 Prioritization of trial data over other data are part of a larger debate about the quality of evidence required to make clinical decisions. Although we agree that trial data, when available, should be considered more heavily, it is impossible for trial data to exist for every important clinical question. Thus, other sources of evidence can be informative for making clinical recommendations.
Tung EL, Davis AM, Laiteerapong N. Guidelines on Glycemic Targets for Persons With Type 2 Diabetes—Reply. JAMA. 2018;320(18):1937–1938. doi:10.1001/jama.2018.13421
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