Strength of Recommendations
Strength Strength Visual Definition
Strong
★★★★
Evidence from two or more "High"
quality studies with consistent findings for
recommending for or against the intervention.
Also requires no reasons to downgrade from
the EtD framework.
Moderate
★★★★
Evidence from two or more "Moderate"
quality studies with consistent findings
recommending for or against the intervention,
prognostic factor, or diagnostic test, or
evidence from a single "High" quality study for
recommending for or against the intervention.
Limited
★★★★
Evidence from two or more "Low"
quality studies with consistent findings or
evidence from a single "Moderate" quality
study recommending for or against the
intervention, or diagnostic or the evidence
is insufficient or conflicting and does not
allow a recommendation for or against the
intervention.
Consensus
★★★★
In the absence of reliable evidence, the clinical
practice guideline development group is
making a recommendation based on their
clinical opinion.
