Strength of Recommendation and Quality of Evidence
Category/Grade
Definition
Strength of Recommendation
A
Good evidence to support a recommendation for or against use.
B
Moderate evidence to support a recommendation for or against use.
C
Poor evidence to support a recommendation.
Quality of Evidence
I
Evidence from ��� 1 properly randomized, controlled trial.
II
Evidence from ��� 1 well-designed clinical trial, without
randomization; from cohort or case-controlled analytic studies
(preferably from > 1 center), from multiple time-series, or from
dramatic results of uncontrolled experiments.
III
Evidence from opinions of respected authorities, based on clinical
experience, descriptive studies, or reports of expert committees.
NOTE: Adapted and reproduced with the permission of the Minister of Public Works and
Government Services Canada
Abbreviations
CT, computerized tomography; MRI, magnetic resonance imaging; IV, intravenous; PJI,
prosthetic joint infection; PO, by mouth; TEA, Total Elbow Arthroplasty; THA, total
hip arthroplasty; TKA, total knee arthroplasty; US, United States
Source
Osmon DR, Berbari EF, Berendt AR, Lew D, Zimmerli W, Steckelberg JM, Rao N,
Hanssen A, Wilson WR. Diagnosis and Management of Prosthetic Joint Infection:
Clinical Practice Guidelines by the Infectious Diseases Society of America. Clin Infect Dis.
2013;56(1):e1-25.
Disclaimer
This Guideline attempts to define principles of practice that should produce high-quality patient
care. It is applicable to specialists, primary care, and providers at all levels. This Guideline
should not be considered exclusive of other methods of care reasonably directed at obtaining the
same results. The ultimate judgment concerning the propriety of any course of conduct must be
made by the clinician after consideration of each individual patient situation.
Neither IGC, the medical associations, nor the authors endorse any product or service associated
with the distributor of this clinical reference tool.
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