Table A2.

Strong vs. weak recommendations*

What is considered	How it affects the recommendation
High evidence	The higher the quality of evidence, the more likely is a strong recommendation
Certainty about the balance of benefits vs. harms and burdens	The larger/smaller the difference between the desirable and undesirable consequences and the certainty around that difference, the more likely is a strong/weak recommendation
Certainty in or similar values	The more certainty or similarity in values and preferences, the more likely is a strong recommendation
Resource implications	The lower/higher the cost of an intervention than the alternative, the more likely is a strong/weak recommendation
Availability and feasibility in LMICs	The less available, the more likely is a weak recommendation
Affordability for LMICs	The less affordable, the more likely is a weak recommendation
Safety of the intervention in LMICs	The less safe in an LMIC, the more likely is a weak recommendation

Adapted from Ref. 1.

*In case of a strong recommendation, we use “we recommend…”; in case of a weak recommendation, we use “we suggest…”