Table 2

Deontic expressions recommended for use by a sample of guideline-developing organisations

Deontic verb or phraseAANAAPDACC/AHAACCPNICENZGGUSPSTF
Should
May
Must
Should be done
Consider
Should consider
Should be considered
May/might be considered
Must be considered
Recommend or is recommended
Is indicated
Suggest or is suggested
Is/may/might be reasonable
Is/can/may be useful
Is/can/may be effective
Offer
Discuss
  • AAN, American Academy of Neurology23; AAPD, American Academy Of Paediatric Dentistry24; ACC, American College of Cardiology25; AHA, American Heart Association25; ACCP, American College of Chest Physicians26; NICE, National Institute for Health and Clinical Excellence (England and Wales). Also provide specific instructions for the rare use of “must” and “must not”14: NZGG, New Zealand Guidelines Group27; USPSTF, US Preventive Services Task Force.13