Table 1.

Simplified GRADE approach.

STRENGTH OF RECOMMENDATION
Strong recommendation	Wording: “we recommend”
	A strong recommendation implies that the benefits clearly outweigh the risks and burdens (or vice versa), and that virtually all informed patients would choose to follow this recommendation.
Weak recommendation	Wording: “we suggest” or “consider”
	A weak recommendation implies that the benefits, risks and burdens are closer together or uncertain, and that patients are likely to make different informed choices based on their individual values and preferences.
No recommendation	Evidence is currently insufficient to balance the benefits, risks and burdens of an intervention.
QUALITY OF EVIDENCE
High	- Clear evidence from a large meta-analysis or at least one large (N ≥ 1000), methodologically sound randomized controlled trial, or - Very large (N ≥ 10000) observational studies showing large and consistent effects
Moderate	- Meta-analysis yielding significant effects, but with few participants (N < 1000), some heterogeneity or limited generalizability, - Randomized trial(s) with small sample size, moderate risk of bias or limited generalizability, or - Large (N ≥ 1000) observational studies showing consistent effects
Low	- Most non-randomized studies, poor-quality randomized trials, small observational studies or expert opinion