Systematic approaches for assessing evidence and making recommendations (such as the GRADE system) hold the promise of improving health outcomes. For diseases with multiple clinical scenarios, recommendations on specific situations can then be weaved together to yield a management pathway for the disease. This exercise is particularly challenging in the case of the inflammatory bowel diseases (IBD), a group of chronic, dynamic and heterogeneous disorders. Underscoring this challenge, the recently developed AGA Crohn’s disease (CD) clinical decision support tool utilized the AGA GRADE recommendations for the induction and maintenance of moderate-severe CD, but also introduced risk stratification in the process of selecting therapy.