Box 1: Grading system for recommendations20
ClassificationDescription
Class of evidence
Class 1Conditions for which there is evidence or general agreement that a given diagnostic evaluation procedure or treatment is beneficial, useful and effective.
Class 2Conditions for which there is conflicting evidence or a divergence of opinion about the usefulness or efficacy of a diagnostic evaluation, procedure or treatment.
Class 2aWeight of evidence or opinion is in favour of usefulness or efficacy.
Class 2bUsefulness or efficacy is less well established by evidence or opinion.
Class 3Conditions for which there is evidence or general agreement that a diagnostic evaluation, procedure or treatment is not useful or effective and in some cases may be harmful.
Grade of evidence
Level AData derived from multiple randomized clinical trials or meta-analyses.
Level BData derived from a single randomized trial, or nonrandomized studies.
Level COnly consensus opinions of experts, case studies, or standard of care.