3
(cont'd)
GRADE Definitions for Certainty of the Evidence, Strength
of Recommendation and Guide to Interpretation
Quality Grade Definition
High We are very confident that the true effect lies close to the
estimate of the effect.
Moderate We are moderately confident in the effect estimate. e true
effect is likely to be close to the estimate of effect, but there is a
possibility that it is substantially different.
Low Our confidence in the estimate is limited. e true effect may be
substantially different from the estimate of effect.
Very low We have very little confidence in the effect estimate. e true
effect is likely to be substantially different from the estimate of
effect.
Evidence gap Available evidence is insufficient to determine true effect.
Grade Strength of Recommendation
For the patient For the clinician
Strong
"AGA
recommends..."
Most individuals
in this situation
would want the
recommended course
and only a small
proportion would not.
Most individuals should receive
the recommended course of action.
Formal decision aids are not likely to
be needed to help individuals make
decisions consistent with their values
and preferences.
Conditional
"AGA suggests..."
e majority of
individuals in this
situation would want
the suggested course,
but many would not.
Different choices would be appropriate
for different patients. Decision aids
may be useful in helping individuals
in making decisions consistent with
their values and preferences. Clinicians
should expect to spend more time
with patients when working towards a
decision.
No recommendation
"AGA makes no
recommendation..."
The confidence in the effect estimate
is so low that any effect estimate is
speculative at this time.
Treatment
