Table 1

A summary of the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system

 GRADE—strength of evidence GRADE—strength of recommendation High quality: Further research is very unlikely to change our confidence in the estimate of effect The trade-offs: Taking into account the estimate size of the effect for main outcomes, the confidence limits around those estimates and the relative value placed on each outcome Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate The quality of the evidence Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate Translation of the evidence into practice in a particular setting: Taking into consideration important factors that could be expected to modify the size of expected effects Very low quality: Any estimate of effect is very uncertain Uncertainty about the baseline risk for the population of interest