Table 7. Grading System for Recommendations Category/Grade
Definition
Level of Evidence Ia Ib
IIa IIb
III IV
Evidence from meta-analysis of randomized controlled trials Evidence from at least one randomized controlled trial
Evidence from at least one controlled study without randomization
Evidence from at least one other type of quasi-experimental study
Evidence from non-experimental descriptive studies, such as comparative studies
Evidence from expert committee reports or opinions or clinical experience of respected authorities or both
Strength of Recommendation A B
C D E
Directly based on category I evidence
Directly based on category II evidence or extrapolated recommendation from category I evidence
Directly based on category III evidence or extrapolated recommendation from category I or II evidence
Directly based on category IV evidence or extrapolated recommendation from category I, II, or III evidence
Based on consensus of the Joint Task Force on Practice Parameters
Abbreviations ACE, angiotensin converting enzyme; FDA, Food and Drug Administration; FEV1
,
forced expiratory volume in one second; LLR, Large local reactions; PEF, Peak expiratory flow rate measurement; PNU, protein nitrogen unit; SLIT, sublingual immunotherapy; VIT, venom immunotherapy
Source Cox L, Nelson H, Lockey R, Calabria C, Chacko T, Finegold I, et al. Immunotherapy: A practice parameter third update. J Allergy Clin Immunol. 2011 Jan;127(1 Suppl):S1-55. Epub 2010 Dec 3.
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 aſter 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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