Table 1.

Modified GRADE system description

Strength of Recommendation	1	Strong: benefits clearly outweigh undesirable effects
	2	Weak or conditional: either lower quality evidence or desirable and undesirable effects are more closely balanced
Quality of evidence	A	High: ‘further research is unlikely to change confidence in the estimate of effect’
	B	Intermediate: ‘further research is likely to have an important impact on the confidence in the estimate of effect and may change the estimate’
	C	Low: ‘further research is very likely to have an important impact on the confidence in the estimate of effect and is likely to change the estimate’
No evidence Available	E	Experts: ‘When the review of the evidence failed to identify any quality studies meeting standards set or evidence was not available, recommendations were formulated expert consensus’