Is the question definitively addressable with RCTs?^{1} YES if: The outcome of interest would be measurable in < 5 years, subjects can ethically be randomized, a control group is plausible and ethical, blinding is potentially possible, a sample size of < 10,000 would provide adequate statistical power If YES, have RCTs been conducted? ➔(1) If YES, then use GRADE^{2} ➔(2) If NO, then use an alternative tool, consider OCEBM^{3} NO if: A duration > 5 years adherence to the intervention is required, randomization is not plausible or ethical, exposure of interest is the cumulative, lifetime effect of health behaviors. ➔ (3) Consider HEALM^{4} |