Table 1.
Levels of Evidence and Support for the Various Primary Esophageal Achalasia Treatment Recommendations4
| Level of evidence | |
|---|---|
| High | At least one RCT or SR/meta-analysis with no concern regarding study quality |
| Moderate | At least one RCT or SR/meta-analysis with minor concerns regarding study quality or, at least one cohort/case-control/diagnostic test design study with no concern regarding study quality |
| Low | At least one cohort/case-control/diagnostic test study with minor concerns regarding study quality, or at least one single arm before-after study or, cross-sectional study with no concerns regarding study quality |
| Very low | At least one cohort/case-control/diagnostic test design study with serious concerns regarding study quality, or at least one single arm before-after study or cross-sectional study with minor/severe concerns regarding study quality |
| Grade of recommendation | |
| Strong for | The benefits of the intervention are greater than the harms based on a high or moderate level of evidence, such that it can be strongly recommended for clinical practice in most cases. |
| Weak for | The benefits and harms of the intervention may vary depending on the clinical situation or patient characteristics. Recommended depending to the clinical situation. |
| Weak against | The benefits and harms of the intervention may vary depending on the clinical situation or patient characteristics. Intervention not be recommended for clinical practice. |
| Strong against | The harms of the intervention are greater than the benefits based on a high or moderate level of evidence, such that it is not recommended for clinical practice. |
| No recommendation | It is not possible to classify the recommendation owing to a lack of evidence or equivocal results. Further evidence is needed. |
RCT, randomized controlled trial; SR, systematic review.