The article discusses the potential disadvantages and harms that patients may face due to the misuse of guidelines in clinical decision-making. Randomized controlled trials (RCTs) are considered the gold standard in evidence synthesis for guidelines, but they have limitations in generalizability and inclusivity. The article highlights the importance of considering individual patient characteristics, provider factors, and the limitations of RCTs in making treatment decisions to avoid potential health inequalities and harm to patients. It emphasizes the need for personalized medicine and the importance of expert opinions in situations where clinical trials are not feasible.