Table 1.

American Academy of Pediatrics defined strategy for recommendation development [9]

Evidence quality	Preponderance of benefit over harm	Balance of benefit and harm	Preponderance of harm over benefit
A. Well-designed RCTs	Strong recommendation	Option	Strong recommendation against
B. RCT’s with minor limitations; overwhelming consistent evidence from observational studies	Recommendation
C. Observational studies (case–control and cohort design)			Recommendation against
D. Expert opinion; case reports; reasoning from first principles	Option	No recommendation

RCT randomized controlled trial