. "Appendix D: Systems for Rating the Strength of Evidence and Clinical Recommendations." Clinical Practice Guidelines We Can Trust. Washington, DC: The National Academies Press, 2011.
The following HTML text is provided to enhance online
readability. Many aspects of typography translate only awkwardly to HTML.
Please use the page image
as the authoritative form to ensure accuracy.
Clinical Practice Guidelines We Can Trust
TABLE D-1 Selected Approaches to Rating Strength of Evidence and Clinical Recommendations
Grades of evidence Randomized trial: High Observational study: Low Any other evidence: Very low
Audience: Guideline developers
Decrease grade if limitations in study quality, important inconsistency of results, uncertainty about the directness of the evidence, imprecise or sparse data, and high risk of reporting bias.
A voluntary, international, collaboration
Increase grade if a very strong association, evidence of a dose–response gradient, presence of all plausible residual confounding would have reduced the observed effect.
