Expert Consensus
Copyright ©The Author(s) 2021.
World J Clin Cases. Mar 26, 2021; 9(9): 2123-2135
Published online Mar 26, 2021. doi: 10.12998/wjcc.v9.i9.2123
Table 1 Qualitative modified approach to grading of evidence[46]
Grading
Qualitative
Evidence
Level IStrongEvidence obtained from multiple relevant high quality randomized controlled trials for effectiveness
Level IIModerateEvidence obtained from at least one relevant high quality randomized controlled trial or multiple relevant moderate or low quality randomized controlled trials
Level IIIFairEvidence obtained from at least one relevant high quality nonrandomized trial or observational study with multiple moderate or low quality observational studies
Level IVLimitedEvidence obtained from multiple moderate or low quality relevant observational studies
Level VConsensus basedOpinion or consensus of large group of clinicians and/or scientists for effectiveness as well as to assess preventive measures, adverse consequences, effectiveness of other measures
Table 2 Guide for strength of recommendations[47]
Strength
Recommendations
StrongThere is high confidence that the recommendation reflects best practice. This is based on: (1) strong evidence for a true net effect (e.g., benefits exceed harms); (2) consistent results, with no or minor exceptions; (3) minor or no concerns about study quality; and/or (4) the extent the panelists’ agreement. Other compelling considerations (discussed in the guideline’s literature review and analyses) may also warrant a strong recommendation.
ModerateThere is moderate confidence that the recommendation reflects best practice. This is based on: (1) good evidence for a true net effect (e.g., benefits exceed harms); (2) consistent results, with minor and/or few exceptions; (3) minor and/or few concerns about study quality; and/or (4) the extent of panelists’ agreement. Other compelling considerations (discussed in the guideline’s literature review and analyses) may also warrant a moderate recommendation.
WeakThere is some confidence that the recommendation offers the best current guidance for practice. This is based on: (1) limited evidence for a true net effect (e.g., benefits exceed harms); (2) consistent results, but with important exceptions; (3) concerns about study quality; and/or (4) the extent of panelists’ agreement. Other considerations (discussed in the guideline’s literature review and analyses) may also warrant a weak recommendation.