Table 2

Levels of evidence

GradeEvidence
1++High quality meta-analyses, systematic reviews of 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 of 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 casual
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 casual
2−Case-control or cohort studies with a high risk of confounding, bias or chance and a significant risk that the relationship is not casual
3Non analytic studies, for example, case reports, case series
4Expert opinion
  • RCT, randomised control trial.