Table 3.

Support for recommendations^a

Strength of Evidence	Language	Evidence
A	Guideline Development Team (GDT) strongly recommends that clinicians routinely provide the intervention to eligible patients	Intervention improves important health outcomes, based on good evidence, and the GDT concludes that benefits substantially outweigh harms and costs
B	GDT recommends that clinicians routinely provide the intervention to eligible patients	Intervention improves important health outcomes, based on 1) good evidence that benefits outweigh harms and costs or 2) fair evidence that benefits substantially outweigh harms and costs
C	GDT makes no recommendation for or against routine provision of the intervention. At the discretion of the GDT, the recommendation may use the language “option,” but must list all the equivalent options.	Evidence is sufficient to determine the benefits, harms, and costs of an intervention, and there is at least fair evidence that the intervention improves important health outcomes. However, the GDT concludes that the balance of the benefits, harms, and costs is too close to justify a general recommendation.
D	GDT recommends against routinely providing the intervention to eligible patients	GDT found at least fair evidence that the intervention is ineffective, or that harms or costs outweigh benefits
I	GDT concludes that the evidence is insufficient to recommend for or against routinely providing the intervention. At the discretion of the GDT, the recommendation may use the language “option” but must list all the equivalent options.	Evidence that the intervention is effective is lacking, of poor quality, or conflicting, and the balance of benefits, harms, and costs cannot be determined

^aSource: Kaiser Foundation Guideline Development Group, Edition 3, September 1, 2004.