| 1A |
Strong recommendation
High quality evidence
|
Desirable effects clearly outweigh undesirable effects or vice versa |
Consistent evidence from randomized controlled trials (RCTs) or exceptionally strong evidence from unbiased observational studies |
Recommendation can apply to most patients in most circumstances.
Further research is unlikely to change the confidence of the estimate of effect |
| 1B |
Strong recommendation
Moderate quality evidence
|
Desirable effects clearly outweigh undesirable effects or vice versa |
Evidence from RCTs with important limitations (inconsistent results, methodological flaws, indirect or imprecise) or unusually strong evidence from unbiased observational studies |
Recommendation can apply to most patients in most circumstances.
Further research (if performed) is likely to have an important impact on the confidence in the estimate of effect and may change the estimate.
|
| 1C |
Strong recommendation
Low quality evidence
|
Desirable effects clearly outweigh undesirable effects or vice versa |
Evidence for at least one critical outcome from RCTs with serious flaws, observational studies or indirect evidence |
Recommendation may change when higher quality evidence becomes available.
Further research (if performed) is likely to have an important impact on the confidence in the estimate of effect and is likely to change the estimate.
|
| 1D |
Strong recommendation
Very low quality evidence (very rarely applicable) |
Desirable effects clearly outweigh undesirable effects or vice versa |
Evidence for at least one of the critical outcomes from unsystematic clinical observation or very indirect evidence |
Recommendation may change when higher quality evidence becomes available.
Any estimate of the effect for at least one critical outcome is very uncertain.
|
| 2A |
Weak recommendation
High quality evidence
|
Desirable effects closely balance with undesirable effects |
Consistent evidence from well performed RCTs or exceptionally strong evidence from unbiased observational studies |
The best action may differ depending on circumstances or patients' or societal views.
Further research is very unlikely to change the confidence in the estimate of effect.
|
| 2B |
Weak recommendation
Moderate quality evidence
|
Desirable effects closely balance with undesirable effects |
Evidence from RCTs with important limitations (inconsistent results, methodological flaws, indirect or imprecise) or unusually strong evidence from unbiased observational studies |
Alternative approach is likely to be better for some patients under some circumstances.
Further research (if performed) is likely to have an important impact on the confidence of the estimate of effect and may change the estimate.
|
| 2C |
Weak recommendation
Low quality evidence
|
Uncertainty in the estimates of desirable and undesirable effects; desirable effects may be closely balanced with undesirable effects |
Evidence for at least one critical outcome from RCTs with serious flaws, observational studies, or indirect evidence |
Other alternatives may be equally reasonable.
Further research is very likely to have important impact on the confidence in the estimate of effect and is likely to change the estimate.
|
| 2D |
Weak recommendation
Very low quality evidence |
Major uncertainty in the estimates of desirable and undesirable effects; desirable effects may be closely balanced with undesirable effects |
Evidence for at least one critical outcome from unsystematic clinical observation or very indirect evidence |
Other alternatives may be equally reasonable.
Any estimate of the effect for at least one critical outcome is very uncertain.
|
