{"id":121,"date":"2010-06-26T21:15:58","date_gmt":"2010-06-26T20:15:58","guid":{"rendered":"https:\/\/blogs.bmj.com\/adc-archimedes\/?p=121"},"modified":"2013-03-15T17:16:20","modified_gmt":"2013-03-15T16:16:20","slug":"it-aint-what-you-say-but-the-way-that-you-say-it","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/adc\/2010\/06\/26\/it-aint-what-you-say-but-the-way-that-you-say-it\/","title":{"rendered":"&#8220;It ain&#8217;t what you say but the way that you say it&#8221;"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" class=\"alignright\" title=\"Sy Oliver, not Bananarama, was the composer\" src=\"http:\/\/www.discogs.com\/image\/A-150-258007-1115121712.gif\" alt=\"\" width=\"79\" height=\"103\" \/>Known and sung about from 1939 onwards, and beloved of puppy-trainers and parents of toddlers, it&#8217;s clear that <em>how<\/em> we say something is often more important than <em>what<\/em> we say. And we now know that this is true for how we write down clinical recommendations and indicate the weight of evidence behind them. (When I say know, we have good randomised experimental data to guide us from the excellent @CharlieNeck and @giordanopg, summarised <a title=\"Practice Guidelines Grading Systems\" href=\"http:\/\/clinicaltrials.gov\/ct2\/show\/NCT00940290\">here.)<\/a><!--more--><\/p>\n<p>These innovative clinician-experimenters took a clinical recommendation, and randomised their paediatric colleagues to have the information presented with one of four different &#8216;grading&#8217; systems. They found the study volunteers differed in their eventual responses &#8230; the GRADE system being the strongest change in direction. This supports a wealth of analogous evidence from the field of implementation science, and should make us think very carefully about not just our critical appraisals, but our information presentation too.<!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Known and sung about from 1939 onwards, and beloved of puppy-trainers and parents of toddlers, it&#8217;s clear that how we say something is often more important than what we say. And we now know that this is true for how we write down clinical recommendations and indicate the weight of evidence behind them. (When I [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/adc\/2010\/06\/26\/it-aint-what-you-say-but-the-way-that-you-say-it\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[79,80,105],"tags":[],"class_list":["post-121","post","type-post","status-publish","format-standard","hentry","category-archimedes","category-critical-appraisal-note","category-service-organisation"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>&quot;It ain&#039;t what you say but the way that you say it&quot; - ADC Online Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/adc\/2010\/06\/26\/it-aint-what-you-say-but-the-way-that-you-say-it\/\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"&quot;It ain&#039;t what you say but the way that you say it&quot; - ADC Online Blog\" \/>\n<meta property=\"og:description\" content=\"Known and sung about from 1939 onwards, and beloved of puppy-trainers and parents of toddlers, it&#8217;s clear that how we say something is often more important than what we say. And we now know that this is true for how we write down clinical recommendations and indicate the weight of evidence behind them. 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