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Guidelines on Overweight and Obesity: Electronic Textbook
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1.i. Caveats to Recommendation Use

In applying these guidelines recommendations, the reader should note some caveats:

  • The emphasis of these guidelines was to identify effective interventions, not to rank-order interventions in terms of relative efficacy or effectiveness. The panel chose not to emphasize comparisons among interventions, because there were few studies that compared long-term outcomes, and, since patient preference often dictates choice of therapy, we wished to present a menu of options rather than a ranked list of choices.
  • When no evidence was available on the efficacy of various treatments, the panel usually rendered no opinion. An absence of studies should not be confused with an absence of effect. While clinicians may wish to use proven therapies in preference to untested therapies, the lack of testing does not prove that the untested therapy does not work.
  • The limitations of RCTs must be kept in mind. The RCT is the primary method for demonstrating efficacy. Often, patients enrolled in RCTs differ from the patients in a primary care practice, and effectiveness in the community may differ from efficacy as measured in an RCT. The potential exists for misinterpretation of clinical trial results. Analysis of endpoints not specified at the outset, post hoc, or subgroup analyses should be viewed as hypothesis-generating rather than hypothesis-testing.
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