Table 8. Quality (internal validity) rating of evidence.

Good	A study (including meta-analyses or systematic reviews) that meets all design-specific criteria* well.
Fair	A study (including meta-analyses or systematic reviews) that does not meet (or it is not clear that it meets) at least one design-specific criterion* but has no known “fatal flaw”.
Poor	A study (including meta-analyses or systematic reviews) that has at least one design-specific* “fatal flaw”, or an accumulation of lesser flaws to the extent that the results of the study are not deemed able to inform recommendations.
I	NACI concludes that there is insufficient evidence (in either quantity and/or quality) to make a recommendation, however other factors may influence decision-making.