Table 1.

IAPAC grading scale for quality of the body of evidence and strength of recommendations [19••]

Quality or strength	Interpretation
Quality of the body of evidence
Excellent	1. RCT evidence without important limitations 2. Overwhelming evidence from observational studies
High	1. RCT evidence with important limitations 2. Strong evidence from observational studies
Medium	1. RCT evidence with critical limitations 2. Observational study evidence without important limitations
Low	1. Observational study evidence with important or critical limitations
Strength of recommendation
Strong	Almost all patients should receive the recommended course of action
Moderate	Most patients should receive the recommended course of action. However, other choices may be appropriate for some patients
Optional	There may be consideration for this recommendation on the basis of individual patient circumstances. Not recommended routinely

RCT randomized, controlled trial