Table 1.

Grading of Recommendations, Assessment, Development and Evaluation (GRADE)

	Criteria
Quality of evidence
High (A)	Further research is unlikely to change confidence in the estimate of the clinical effect
Moderate (B)	Further research may change confidence in the estimate of the clinical effect
Low (C)	Further research is very likely to impact confidence on the estimate of clinical effect
Very low (D)	Any estimate of effect is uncertain
Strength of recommendation
Strong (1)	Factors influencing the strength of the recommendation included the quality of the evidence, presumed patient important outcomes, and cost
Weak (2)	Variability in preferences and values, or more uncertainty. Recommendation is made with less certainty, higher cost or resource consumption

Evidence level was graded down if there was only an abstract, poor quality or inconsistency between studies; level was graded up if there was a large effect size.