Revised grading system for recommendations in evidence-based guidelines
| Grade | Evidence |
| 1++ | High quality meta-analyses, systematic reviews of randomised controlled trials (RCTs) or RCTs with a very low risk of bias |
| 1+ | Well conducted meta-analyses, systematic reviews of RCTs or RCTs with a low risk of bias |
| 1 | Meta-analyses, systematic reviews or RCTs or RCTs with a high risk of bias |
| 2++ | High quality systematic reviews of case–control or cohort studies or high quality case–control or cohort studies with a very low risk of confounding, bias or chance and a high probability that the relationship is causal |
| 2+ | Well conducted case–control or cohort studies with a low risk of confounding, bias, or chance and a moderate probability that the relationship is causal |
| 2 | Case–control or cohort studies with a high risk of confounding, bias or chance and a significant risk that the relationship is not causal |
| 3 | Non-analytical studies—for example, case reports, case series |
| 4 | Expert opinion |