Table 3. Quality and certainty of evidence grades.

Grade	Description
High	Very confident the true effect lies close to that of the estimate of the effect.
Moderate	Moderately confident in the effect estimate. The true effect is likely to be close to the estimate of the effect. There is a possibility that it is substantially different.
Low	Limited confidence in the effect estimate. The true effect may be substantially different from the estimate of the effect.
Very Low	Little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect.

^aAdapted from: GRADE Handbook, Section 5. Quality of Evidence; https://gdt.gradepro.org/app/handbook/handbook.html.