Table A2.

Strong versus Weak Recommendations^*

What is Considered	How it affects the recommendation
High evidence	The higher the quality of evidence, the more likely 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 a strong/weak recommendation.
Certainty in or similar values	The more certainty or similarity in values and preferences, the more likely a strong recommendation.
Resource implications	The lower/higher the cost of an intervention compared to the alternative the more likely a strong/weak recommendation.
Availability and feasibility in LMICs	The less available, the more likely a weak recommendation.
Affordability for LMICs	The less affordable, the more likely a weak recommendation.
Safety of the intervention in LMICs	The less safe in an LMIC, the more likely a weak recommendation.

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

Adapted from Dondorp AM, Dünser MW, Schultz MJ, eds., 2019. Sepsis Management in Resource–limited Settings. Springer. doi.org/10.1007/978-3-030-03143-5