Table 4

Level of evidence and strength of recommendation.22-24

LevelStrengthLevelDescription
Level I high degree of certaintyStandardABased on consistent class I evidence (well-designed RCT)
BSingle class I study or consistent class II evidence (especially when circumstances preclude RCTS)
Level II moderate degree of certaintyGuidelineCClass II evidence (less well-designed RCT or one or more observational study) or a preponderance of class III evidence
Level III unclear degree of certaintyOptionD (or I)Class III evidence (case series, case reports, and expert opinion)