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. Author manuscript; available in PMC: 2014 Dec 1.
Published in final edited form as: Pediatr Infect Dis J. 2013 Dec;32(12):1303–1307. doi: 10.1097/INF.0000000000000080

Table 1.

System for grading strength of recommendations and quality of supporting evidence

Strength of Recommendation Quality of Evidence for Recommendation^

  1. Strong recommendation for the statement

  2. Moderate recommendation for the statement

  3. Optional recommendation for the statement

  • I: One or more randomized trials in children† with clinical outcomes and/or validated laboratory endpoints

  • I*: One or more randomized trials in adults with clinical outcomes and/or validated laboratory endpoints with accompanying data in children† from one or more well-designed, nonrandomized trials or observational cohort studies with long-term clinical outcomes

  • II: One or more well-designed, nonrandomized trials or observational cohort studies in children† with long-term clinical outcomes

  • II*: One or more well-designed, nonrandomized trials or observational cohort studies in adults with long-term clinical outcomes with accompanying data in children† from one or more smaller nonrandomized trials or cohort studies with clinical outcome data

  • III: Expert opinion
†

Studies that include children or children/adolescents but not studies limited to postpubertal adolescents.

^

In circumstances where there is level I or level II evidence from studies in adults with accompanying data in children that come only from non-randomized trials or cohort studies with clinical outcomes, experts assigned a rating of I* or II*, respectively, if they judged the evidence from children sufficient to support findings from adult studies. In circumstances where there is level I or level II evidence from studies in adults with no or almost no accompanying data in children, experts assigned a rating of III.