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1A
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Strong recommendation, high-quality evidence
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Benefits clearly outweigh risk and burdens, or vice versa
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RCTs without important limitations or overwhelming evidence from observational studies
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Strong recommendation, can apply to most patients in most circumstances without reservation
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1B
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Strong recommendation, moderate-quality evidence
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Benefits clearly outweigh risk and burdens, or vice versa
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RCTs with important limitations (inconsistent results, methodological flaws, indirect or imprecise) or exceptionally strong evidence from observational studies
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Strong recommendation, can apply to most patients in most circumstances without reservation
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1C
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Strong recommendation, low-quality or very low-quality evidence
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Benefits clearly outweigh risk and burdens, or vice versa
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Observational studies or case series
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Strong recommendation but may change when higher quality evidence becomes available
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2A
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Weak recommendation, high-quality evidence
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Benefits closely balanced with risks and burden
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RCTs without important limitations or overwhelming evidence from observational studies
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Weak recommendation, best action may differ depending on circumstances or patients’ or societal values
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2B
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Weak recommendation, moderate-quality evidence
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Benefits closely balanced with risks and burden
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RCTs with important limitations (inconsistent results, methodological flaws, indirect or imprecise) or exceptionally strong evidence from observational studies
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Weak recommendation, best action may differ depending on circumstances or patients’ or societal values
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2C
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Weak recommendation, low-quality or very low-quality evidence
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Uncertainty in the estimates of benefits, risks, and burden; benefits, risk and burden may be closely balanced
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Observational studies or case series
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Very weak recommendation; other alternatives may be equally reasonable
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