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A classification of quality of evidence and strength of recommendation system. It constitutes the basis for the development of clinical practice guidelines. It classifies the evidence into high, moderate, low or very low.
What is GRADE (Grading of Recommendations, Assessment, Development and Evaluation) system.
A-High Further research is very unlikely to change our confidence in the estimate of effect.
Several high-quality studies with consistent results
In special cases: one large, high-quality multi-centre trial
B. Moderate -Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. One high-quality study. Several studies with some limitations.
C- Low 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. One or more studies with severe limitations.
D- Very low - Any estimate of effect is very uncertain.
Expert opinion. No direct research evidence
One or more studies with very severe limitations