Clin Med
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The development of evidence-based guidelines requires scrupulous attention to the method of critical appraisal. Many critical appraisal systems give 'gold standard' status to randomised controlled trials (RCTs) due to their ability to limit bias. ⋯ A review of the Scottish Intercollegiate Guidelines Network, the Grading of Recommendations Assessment, Development and Evaluation, the Graphic Appraisal Tool for Epidemiology and the National Service Framework for Long Term Conditions grading systems was therefore undertaken. A matrix was developed suggesting the optimum grading system for the type of guideline being developed or question being addressed by a specialist society.
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Lactose intolerance, the inability to metabolise lactose in milk and dairy products is due to deficiency of lactase in the gastrointestinal (GI) tract resulting in multiple GI and systemic symptoms. Diagnosis requires a degree of clinical suspicion.