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. 2021 Aug 25;10(1):15–40. doi: 10.1002/ueg2.12133

TABLE 2.

Descriptors of grading of strength of recommendations

Descriptor Meaning Wording used for the recommendation
A–Strength high Evidence or general accord that the recommendation is useful or effective. Further research is very unlikely to change our confidence in the estimate of effect. ..has to be…..
…is to be…..
….shall…
B–Strength moderate Conflicting evidence or discordant opinions that the recommendation is useful or effective. The weight of evidence/opinion is in favour of utility. Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. …should…..
…can…..
C–Strength low Conflicting evidence or discordant opinions that the recommendation is useful or effective. Further research is VERY likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. …..could….
D–Strength very low Any estimate of effect is very uncertain. ….may…..