The article discusses the GRADE system, which classifies recommendations in guidelines as either strong or weak. Strong recommendations are made when there is high confidence that the desirable effects of an intervention outweigh the undesirable effects, while weak recommendations indicate that the desirable effects are likely to outweigh the undesirable effects, but the panel is less certain. The strength of a recommendation provides clear guidance to patients, clinicians, and policymakers. Strong recommendations are applicable to most situations, whereas weak recommendations require more nuanced decision-making and may need to be discussed with patients and families. The strength of a recommendation is determined by four key factors: the balance between desirable and undesirable consequences, the quality of evidence, uncertainty about values and preferences, and cost. The article also highlights that strong recommendations may not be important from all perspectives, and that guidelines should consider various factors beyond the strength of a recommendation, such as the prevalence of the health problem and equity considerations. Additionally, it suggests that recommendations for research contexts may be appropriate when there is insufficient evidence to support clinical use.The article discusses the GRADE system, which classifies recommendations in guidelines as either strong or weak. Strong recommendations are made when there is high confidence that the desirable effects of an intervention outweigh the undesirable effects, while weak recommendations indicate that the desirable effects are likely to outweigh the undesirable effects, but the panel is less certain. The strength of a recommendation provides clear guidance to patients, clinicians, and policymakers. Strong recommendations are applicable to most situations, whereas weak recommendations require more nuanced decision-making and may need to be discussed with patients and families. The strength of a recommendation is determined by four key factors: the balance between desirable and undesirable consequences, the quality of evidence, uncertainty about values and preferences, and cost. The article also highlights that strong recommendations may not be important from all perspectives, and that guidelines should consider various factors beyond the strength of a recommendation, such as the prevalence of the health problem and equity considerations. Additionally, it suggests that recommendations for research contexts may be appropriate when there is insufficient evidence to support clinical use.