TABLE 2.

Grading of Recommendations assessment, Development and Evaluation (GRaDE): Strength of evidence and grading of recommendations

Quality of evidence
Grade A	Well-designed, randomized controlled trials with consistent and directly applicable results
Grade B	Randomized trials with limitations including inconsistent results or major methodological weaknesses
Grade C	Observational studies, and from generalization from randomized trials in one group of patients to a different group of patients
Strength of recommendations
Grade 1	Strong recommendation, with desirable effects clearly outweighing undesirable effects (or vice versa)
	Wording of recommendation: We recommend that…..
Grade 2	Weak recommendation, with desirable effects closely balanced with undesirable effects
	Wording of recommendation: We suggest that…..
When there is insufficient evidence or no consensus	Wording of recommendation: There was no consensus on a recommendation for or against …

Adapted from reference 9