Evidence map›Paper›PMID 41986915›Full record

ArticleGut microbes2026

When probiotics guidelines differ: a practical guide for clinicians and researchers.

Geoffrey A Preidis, Hania Szajewska, Marla Cunningham, Howard Bauchner, Daniel J Merenstein

Abstract readEditorial
In one paragraph

Article in Gut microbes, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Geoffrey A PreidisDepartment of Pediatrics, Division of Gastroenterology, Hepatology & Nutrition, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, United States.ORCID 0000-0002-2206-6452
Hania SzajewskaDepartment of Paediatrics, The Medical University of Warsaw, Warsaw, Poland.ORCID 0000-0002-4596-2874
Marla CunninghamInternational Scientific Association for Probiotics and Prebiotics, Brisbane, Queensland, Australia.
Howard BauchnerBoston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, United States.
Daniel J MerensteinDepartment of Family Medicine, Georgetown University Medical Center, Washington, DC, United States.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Many professional organizations publish clinical practice guidelines for the use of probiotics in gastrointestinal disorders. Generally, no two guidelines align perfectly, and some differ markedly. These discrepancies occur because clinical practice guidelines are not purely mechanical outputs of data synthesis. They are shaped by structured interpretation, value judgments, and predefined thresholds for uncertainty. These elements become particularly visible when effect sizes are small, heterogeneity is high, and outcomes vary in clinical relevance-as is the case with probiotic research. This article examines why discordance among probiotic guidelines is predictable and provides practical guidance for clinicians who must decide among conflicting recommendations to make the most appropriate management decisions for their patients. Guidance is also provided for investigators who seek to improve the quality of evidence, confidence in recommendations, and accurate communication of probiotic research to clinicians, patients, and the broader scientific ecosystem.

Indexed as

Gastrointestinal DiseasesPractice Guidelines as TopicProbioticsHumansCertainty of evidencenecrotizing enterocolitisnetwork meta-analysissystematic reviews

Identifiers

PMID41986915
PMCPMC13085939

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.