| Grade: 1A |
|---|
| Description of recommendation |
| Strong recommendation, high-quality evidence |
| Benefit vs risk |
| Benefits clearly outweigh risk and burdens, or vice versa |
| Methodologic quality of supporting evidence |
| RCTs without important limitations or overwhelming evidence from observational studies |
| Implications |
| Strong recommendation, can apply to most patients in most circumstances without reservation |
| Grade: 1B |
| Description of recommendation |
| Strong recommendation, moderate-quality evidence |
| Benefit vs risk |
| Benefits clearly outweigh risk and burdens, or vice versa |
| Methodologic quality of supporting evidence |
| RCTs with important limitations (inconsistent results, methodologic flaws, indirect, or imprecise) or exceptionally strong evidence from observational studies |
| Implications |
| Strong recommendation, can apply to most patients in most circumstances without reservation |
| Grade: 1C |
| Description of recommendation |
| Strong recommendation, lowquality or very-low-quality evidence |
| Benefit vs risk |
| Benefits clearly outweigh risk and burdens, or vice versa |
| Methodologic quality of supporting evidence |
| Observational studies or case series |
| Implications |
| Strong recommendation but may change when higher quality evidence becomes available |
| Grade: 2A |
| Description of recommendation |
| Weak recommendation, highquality evidence |
| Benefit vs risk |
| Benefits closely balanced with risks and burdens |
| Methodologic quality of supporting evidence |
| RCTs without important limitations or overwhelming evidence from observational studies |
| Implications |
| Weak recommendation, best action may differ depending on circumstances or patients’ or societal values |
| Grade: 2B |
| Description of recommendation |
| Weak recommendation, moderate-quality evidence |
| Benefit vs risk |
| Benefits closely balanced with risks and burdens |
| Methodologic quality of supporting evidence |
| RCTs with important limitations (inconsistent results, methodologic flaws, indirect, or imprecise) or exceptionally strong evidence from observational studies |
| Implications |
| Weak recommendation, best action may differ depending on circumstances or patients’ or societal values |
| Grade: 2C |
| Description of recommendation |
| Weak recommendation, lowquality or very-low-quality evidence |
| Benefit vs risk |
| Uncertainty in the estimates of benefits and risk, and burdens; Risk, benefit, and burdens may be closely balanced |
| Methodologic quality of supporting evidence |
| Observational studies or case series |
| Implications |
| Very weak recommendations; Other alternatives may be reasonable |