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In the confusing and fast-changing world of medicine, few voices carry as much weight as that of the World Health Organization.

But a new, Canadian-led analysis takes a poke at that reputation, concluding the UN agency often makes strong recommendations on how to treat or prevent illness based on weak evidence, potentially leading to patients getting less-than-optimum care.

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The study concluded that 73 of 289 strong recommendations the agency issued over a recent five-year stretch — on topics ranging from maternal health to tuberculosis — were based on low-quality evidence and warranted only conditional advice.

“Historically, WHO recommendations have been extremely untrustworthy and not evidence-based,” said Dr. Gordon Guyatt, the study’s lead author. “Things have gotten better, but there is still a ways to go. … If the truth is that an intervention is ineffective or minimally effective, [patients and health workers] would want to know this.”