Skip to Main Content
TABLE 2

Grading of Recommendations Assessment, Development and Evaluation (GRADE) System14,–,18 

1. Classification of evidence  
    Grade  
        A. High Further research is very unlikely to change our confidence in the estimate of effect 
        B. Moderate Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate 
        C. Low Further research is very likely to have an important impact on confidence in the estimate of effect and is likely to change the estimate 
        D. Very low Any estimate of effect is very uncertain 
2. Recommendations: The strength of a recommendation reflects the extent to which we can be confident that desirable effects of an intervention outweigh undesirable effects.  
    Strong When the desirable effects of an intervention clearly outweigh the undesirable effects, or clearly do not.
  • For patients—most people in your situation would want the recommended course of action and only a small proportion would not

  • For clinicians—most patients should receive the recommended course of action

  • For policy makers—the recommendation can be adopted as a policy in most situations

 
    Weak Evidence suggests that desirable and undesirable effects are closely balanced or the quality of evidence is low.
  • For patients—most people in your situation would want the recommended course of action, but many would not

  • For clinicians—you should recognize that different choices will be appropriate for different patients and you must help each patient to arrive at a management decision consistent with his or her values and preferences.

  • For policy makers—policy making will require substantial debate and involvement of many stakeholders

 
    No specific recommendations The advantages and disadvantages of the recommendations are equivalent or where there is insufficient evidence on which to formulate a recommendation 
1. Classification of evidence  
    Grade  
        A. High Further research is very unlikely to change our confidence in the estimate of effect 
        B. Moderate Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate 
        C. Low Further research is very likely to have an important impact on confidence in the estimate of effect and is likely to change the estimate 
        D. Very low Any estimate of effect is very uncertain 
2. Recommendations: The strength of a recommendation reflects the extent to which we can be confident that desirable effects of an intervention outweigh undesirable effects.  
    Strong When the desirable effects of an intervention clearly outweigh the undesirable effects, or clearly do not.
  • For patients—most people in your situation would want the recommended course of action and only a small proportion would not

  • For clinicians—most patients should receive the recommended course of action

  • For policy makers—the recommendation can be adopted as a policy in most situations

 
    Weak Evidence suggests that desirable and undesirable effects are closely balanced or the quality of evidence is low.
  • For patients—most people in your situation would want the recommended course of action, but many would not

  • For clinicians—you should recognize that different choices will be appropriate for different patients and you must help each patient to arrive at a management decision consistent with his or her values and preferences.

  • For policy makers—policy making will require substantial debate and involvement of many stakeholders

 
    No specific recommendations The advantages and disadvantages of the recommendations are equivalent or where there is insufficient evidence on which to formulate a recommendation 
Close Modal

or Create an Account

Close Modal
Close Modal