Table 2.

Grading of recommendations

Grading	Definition	Evidence level	Net benefit (median, by Delphi score)
Strong recommendation	The benefit of the intervention is greater than the harm and the evidence level is high. The intervention can be strongly recommended in most contexts in clinical practice.	High or moderate	≥7
Weak recommendation	The benefit and harm of the intervention may vary depending on the clinical situation or patient/social value.	High or moderate	4-6
	The intervention is recommended conditionally according to the clinical circumstances.	Low	≥7
Against recommendation	The harm of the intervention is greater than the benefit, and the evidence level is high or moderate; thus, the intervention may not be recommended in clinical practice.	High or moderate	≤3
Insufficient	It is not possible to determine the recommendation grade because of the lack of evidence or a low level of evidence; thus, further evidence is needed.	Low	≤6