Table 1.

Strength of Panelists' Recommendations Based on Available Evidence

Rating	Definition
A: Strongly recommends	The recommendation is based on good evidence that the service or intervention can improve important health outcomes. Evidence includes consistent results from well-designed, well-conducted studies in representative populations that directly assess effects on health outcomes.
B: Recommends	The recommendation is based on fair evidence that the service or intervention can improve important health outcomes. The evidence is sufficient to determine effects on health outcomes, but the strength of the evidence is limited by the number, quality, or consistency of the individual studies; generalizability to routine practice; or indirect nature of the evidence on health outcomes.
C: Recommends	The recommendation is based on expert opinion.
D: Recommends against	The recommendation is based on expert opinion.
E: Recommends against	The recommendation is based on fair evidence that the service or intervention does not improve important health outcomes or that harms outweigh benefits.
F: Strongly recommends against	The recommendation is based on good evidence that the service or intervention does not improve important health outcomes or that harms outweigh benefits.
I: Recommends neither for nor against	The panel concludes that the evidence is insufficient to recommend for or against providing the service or intervention because evidence is lacking that the service or intervention improves important health outcomes, the evidence is of poor quality, or the evidence is conflicting. As a result, the balance of benefits and harms cannot be determined.