Table 1

Grading of Recommendations Assessment, Development and Evaluation (GRADE) system [24] for rating quality of evidence and strength of recommendation

Factor

Description


Evidence:

High quality

Considerable confidence of the estimate of effect. Further research is very unlikely to change our confidence in the estimated effect.

Moderate quality

Confidence that the estimate is close to the truth. Further research is likely to have an important impact on our confidence in the estimate effect and may change the estimate.

Low quality

Limited confidence in the effect. Further research is likely to have an important impact on our confidence in the estimate effect and is likely to change the estimate.

Very low quality

Little confidence in the effect estimate. Any change of effect is uncertain.

Recommendation:

Strong: 'We recommend...'

A strong recommendation indicates that most well informed people will make the same choice

Weak: 'We suggest...'

A weak recommendation indicates that the majority of well informed people will make the same choice but a substantial minority will not

Uncertain: 'We cannot recommend...'

No specific recommendation for or against


Factors influencing the strength of the recommendation include evidence quality, risk/benefit aspects of presumed patient-important outcomes, costs and uncertainty concerning values and preferences.

Undén et al. BMC Medicine 2013 11:50   doi:10.1186/1741-7015-11-50

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