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| Evidence obtained from systematic reviews, high-quality diagnostic studies, prospective studies, or randomized controlled trials |
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Evidence obtained from systematic reviews, lesser-quality diagnostic
studies, prospective studies, or randomized controlled trials (eg, weaker diagnostic criteria and reference standards, improper randomization, no blinding, less than 80% follow-up) |
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| Case-control studies or retrospective studies |
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Strong evidence.
A preponderance of level I and/or level II studies support the recommendation. This must include at least 1 level I study |
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Moderate evidence.
A single high-quality randomized controlled trial or a preponderance of level II studies support the recommendation |
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Weak evidence.
A single level II study or a preponderance of level III and IV studies, including statements
of consensus by content experts, support the recommendation |
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Conflicting evidence.
Higher-quality studies conducted on
this topic disagree with respect to their conclusions. The recommendation is based on these conflicting studies |
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Theoretical/Foundational evidence.
A preponderance of evidence from animal
or cadaver studies, from conceptual models/principles, or from basic science/bench research support this conclusion |
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Expert opinion.
Best practice based on the clinical experience of the guidelines development team |
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