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Table 1. Grading Recommendations
Grade Description
1 Recommendation: indicates confidence that the benefits of the
intervention clearly outweigh harms.
2 Suggestion: indicates greater uncertainty; although the benefits of the
statement are still viewed as outweighing the harms, balance of benefits
and harms is more difficult to judge, or the benefits or the harms may
be less clear. With a suggestion, patient values and preferences may
be more variable, and this can influence the clinical decision that is
ultimately made.
Grade Strength of Evidence
A High: high confidence that the evidence reflects the true effect. Further
research is very unlikely to change our confidence in the estimate of effect.
B Moderate: moderate confidence that the evidence reflects the true effect.
Further research may change our confidence in the estimate of effect
and may change the estimate.
C Low: low confidence that the evidence reflects the true effect. Further
research is likely to change our confidence in the estimate of effect and is
likely to change the estimate.
