Table 4

Grades of recommendations

GradeType of evidence
A At least one meta-analysis, systematic review or RCT rated as 1++ and directly applicable to the target population or
A systematic review of RCTs or a body of evidence consisting principally of studies rated as 1+ directly applicable to the target population and demonstrating overall consistency of results
BA body of evidence including studies rated as 2++ directly applicable to the target population and demonstrating overall consistency of results or
Extrapolated evidence from studies rated as 1++ or 1+
C A body of evidence including studies rated as 2+ directly applicable to the target population and demonstrating overall consistency of results or
Extrapolated evidence from studies rated as 2++
DEvidence level 3 or 4 or
Extrapolated evidence from studies rated as 2+
Important practical points for which there is no research evidence, nor is there likely to be any research evidence. The guideline committee wishes to emphasise these as good practice points
  • RCT, randomised controlled trial.