Table 2.

Criteria that influence the strength and direction in the GRADE EtD frameworks

Criteria	How the criterion influences the direction and strength of a recommendation
1. Problem	The judgment about the problem is determined by the importance and frequency of the health care issue that is addressed (burden of disease, prevalence, cost, or baseline risk). If the problem is of great importance an intervention is more likely to exert large effects and a strong recommendation may be more likely. However, this is a guiding principle and not universally applicable to all recommendations.
2. Values and preferences or the importance of outcomes	This describes how important health outcomes are to those affected, how variable they are, and whether there is uncertainty about this.
3. Certainty in the evidence about the health benefits and harm	The higher the certainty in the evidence, the more likely is a strong recommendation.
4. Health benefits and harms and burden and their balance	This requires an evaluation of the absolute effects of both the benefits and harms and their importance including the judgment about criterion 2. The greater the net benefit or net harm, the more likely is a strong recommendation for or against the option.
5. Resource implications	This describes how resource intense an option is, if it is cost-effective and if there is incremental benefit. The more advantageous or clearly disadvantageous these resource implications are, the more likely is a strong recommendation.
6. Equity	The greater the likelihood to reduce inequities or increase equity and the more accessible an option is, the more likely is a strong recommendation.
7. Acceptability	The greater the acceptability of an option to all or most stakeholders, the more likely is a strong recommendation.
8. Feasibility	The greater the acceptability of an option to all or most stakeholders, the more likely is a strong recommendation.