Quality: High
Future research unlikely to change confidence in estimate of effect; e.g. multiple well designed, well conducted clinical trails
Quality: Moderate
Further research likely to have an important impact on confidence in estimate of effect and may change the estimate e.g. limited clinical trials, inconsistency of results or study limitations
Quality: Low
Further research very likely to have a significant impact in the estimate of effect and is likely to change the estimate e.g. small number of clinical studies or cohort observations
Quality: Very low
The estimate of effect is very uncertain; e.g. case studies; consensus opinion

Modified with permission from: Guyatt GH, et al. BMJ 2008;336:926