Recommendation Grading
Class/Level Definition Evidence Class I
Class II Class III
Class IV
A randomized, controlled clinical trial with masked or objective outcome assessment fulfilling 5 criteria
A randomized, controlled clinical trial or a prospective matched cohort study with masked or objective outcome assessment fulfilling 4 criteria
All other controlled trials Studies not meeting Class I, II or III criteria including consensus or expert opinion
Recommendation Levels A B
C U
Established as effective, ineffective or harmful (≥ 2 Class I trials) Probably effective, ineffective or harmful (one Class I or 2 Class II studies)
Possibly effective, ineffective or harmful (1 Class II study or two Class III studies)
Data inadequate or conflicting Please see full-text guidelines for details.
Abbreviations ACE, angiotensin-converting-enzyme; AED, antiepileptic drug; ARB, angiotensin receptor blockers; bid, twice a day; NSAID, nonsteroidal anti-inflammatory drug; OTC, over the counter; SSRI, selective serotonin reuptake inhibitor; SNRI, serotonin norepinephrine reuptake inhibitor; subcut, subcutaneous; tid, three times a day
Source Silberstein SD, Holland S, Freitag F, Dodick D, Argoff C, Ashman E. Evidence-based guideline update: pharmacologic treatment for episodic migraine prevention in adults. Report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology 2012;78:1337–1345. Read the guideline and disclosures: http:// www.neurology.org/content/78/17/1337.full.pdf+html Holland S, Silberstein SD, Freitag F, Dodick D, Argoff C, Ashman E. Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults. Report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology 2012;78:1346–1353. Read the guideline and disclosures: http://www.neurology.org/content/78/17/1346.full.pdf+html
Disclaimer
This Guideline reproduction is based on an assessment of current scientific and clinical information. It is not intended to include all possible proper methods of care for a particular neurologic problem or all legitimate criteria for choosing to use a specific procedure. It is also not intended to exclude any reasonable alternative methodologies. Specific patient care decisions are the prerogative of the patient and the physician caring for the patient, based on all of the circumstances involved. These Guidelines attempt to define principles of practice that should produce high-quality patient care. They are applicable to specialists, primary care, and providers at all levels. See published guidelines for complete text. These Guidelines 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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