Strength of Recommendation Taxonomy (SORT)
SORT is a system that helps doctors and researchers judge how strong medical recommendations are, based on the quality of evidence. It focuses on whether the evidence shows real benefits to patients, like living longer or feeling better, rather than just lab results or theory.
At a glance
Use when
Grading clinical recommendations in primary care, especially when patient-oriented evidence is available and clear communication of recommendation strength is needed.
Avoid when
Conducting comprehensive health technology assessments that require evaluation of cost, safety, or organizational impact beyond clinical effectiveness.
Inputs
Clinical evidence from individual studies or bodies of literature, focusing on patient-oriented outcomes, study design, quality, consistency, and quantity of evidence.
Outputs
Graded recommendations (A, B, C) and levels of evidence (1–3) for clinical interventions based on the strength and type of supporting evidence.
How it works
The Strength of Recommendation Taxonomy (SORT) is a grading system developed to standardize the assessment of evidence and strength of recommendations in primary care literature. It evaluates evidence based on quality, quantity, and consistency, with an emphasis on patient-oriented outcomes. Recommendations are graded as A (consistent, high-quality patient-oriented evidence), B (inconsistent or limited-quality patient-oriented evidence), or C (consensus, usual practice, opinion, disease-oriented evidence, or case series). Individual studies are assigned levels of evidence from 1 to 3. SORT is grounded in the information mastery framework and is adopted by multiple family medicine journals.
- HTA domains
- Clinical Effectiveness, Patient and Social Aspects
- Categories
- Appraisal
- Assumptions
- Patient-oriented outcomes are more meaningful for clinical decision-making than disease-oriented or surrogate outcomes; consistent grading improves evidence translation into practice.
- Strengths
- Focuses on patient-centered outcomes such as changes in morbidity and mortality,Provides a simple, consistent framework for grading both individual studies and bodies of evidence,Adopted by multiple primary care journals, supporting widespread use and standardization
- Limitations
- May not be as detailed or nuanced as other grading systems like GRADE,Limited guidance on incorporating economic or organizational factors,Primarily designed for primary care, potentially limiting applicability in specialized fields
- Also known as
- SORT, Strength of Recommendation Taxonomy
Questions this answers
- › How strong is the recommendation for a particular clinical intervention?
- › What type of evidence supports a clinical recommendation?
- › Is the evidence based on patient-oriented outcomes rather than disease-oriented or surrogate endpoints?
- › How consistent and high-quality is the body of evidence behind a recommendation?
- › Can the strength of evidence from individual studies be systematically graded?
- › How can clinicians interpret and apply research findings to patient care?
References & sources
Related methods
Similar by meaning
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