Table 1.

Categories of quality of evidence and corresponding meaning and interpretation along with implications on various stakeholders

Quality of evidence	Meaning	Interpretation
High	We are confident that the true effect lies close to that of the estimate of the effect.	Further research is very unlikely to change our confidence in the estimate of the effect.
Moderate	We are moderately confident in the estimate of the effect; the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.	Further research is likely to have an impact on our confidence in the estimate of the effect and may change the estimate.
Low	Our confidence in the estimate of the effect is limited; the true effect may be substantially different from the estimate of the effect.	Further research is very likely to have an impact on our confidence in the estimate of the effect and is likely to change the estimate.
Very low	We have very little confidence in the estimate of the effect; the true effect is likely to be substantially different from the estimate of the effect.	Any estimate of the effect is very uncertain.
Implications for	Strong recommendation	Conditional recommendation
Patients	Most individuals in this situation would want the recommended course of action, and only a small proportion would not.	Most individuals in this situation would want the suggested course of action, but many would not.
Clinicians	Most individuals should receive the test. Formal decision aids are not likely to be needed to help individual patients make decisions consistent with their values and preferences.	Recognize that different choices will be appropriate for individual patients and that you must help each patient arrive at a management decision consistent with his or her values and preferences. Decision aids may be useful in helping individuals to make decisions consistent with their values and preferences.
Policymakers	The recommendation can be adopted as policy in most situations. Compliance with this recommendation according to the guideline could be used as a quality criterion or performance indicator.	Policymaking will require substantial debate and involvement of various stakeholders.