Table 1 GRADE strength of recommendations ratings [89]
Strength | Wording | Symbol | Definition |
|---|---|---|---|
Strong recommendation for the use of an intervention | ‘Offer’ (or similar, e.g., ‘use’, ‘provide’, ‘take’, ‘investigate’, etc.) | ↑↑ | Benefits of the intervention outweigh the risks; most patients would choose the intervention while only a small proportion would not; for clinicians, most of their patients would receive the intervention; for policymakers, it would be a useful performance indicator |
Weak recommendation for the use of an intervention | ‘Consider’ | ↑ | Risks and benefits of the intervention are finely balanced; many patients would choose the intervention, but many would not; clinicians would need to consider the pros and cons for the patient in the context of the evidence; for policymakers it would be a poor performance indicator where variability in practice is expected |
No recommendation | Θ | Insufficient evidence to support any recommendation | |
Strong recommendation against the use of an intervention | ‘Do not offer’ | ↓↓ | Risks of the intervention outweigh the benefits; most patients would not choose the intervention while only a small proportion would; for clinicians, most of their patients would not receive the intervention |