Skip to main content

Table 1 GRADE system to evaluate the level of evidence and recommendation

From: Kidney and uro-trauma: WSES-AAST guidelines

Grade of recommendationClarity of risk/benefitQuality of supporting evidenceImplications
1A
 Strong recommendation, high-quality evidenceBenefits clearly outweigh risk and burdens, or vice versaRCTs without important limitations or overwhelming evidence from observational studiesStrong recommendation, applies to most patients in most circumstances without reservation
1B
 Strong recommendation, moderate-quality evidenceBenefits clearly outweigh risk and burdens, or vice versaRCTs with important limitations (inconsistent results, methodological flaws, indirect analyses or imprecise conclusions) or exceptionally strong evidence from observational studiesStrong recommendation, applies to most patients in most circumstances without reservation
1C
 Strong recommendation, low-quality or very low-quality evidenceBenefits clearly outweigh risk and burdens, or vice versaObservational studies or case seriesStrong recommendation but subject to change when higher quality evidence becomes available
2A
 Weak recommendation, high-quality evidenceBenefits closely balanced with risks and burdenRCTs without important limitations or overwhelming evidence from observational studiesWeak recommendation, best action may differ depending on the patient, treatment circumstances, or social values
2B
 Weak recommendation, moderate-quality evidenceBenefits closely balanced with risks and burdenRCTs with important limitations (inconsistent results, methodological flaws, indirect or imprecise) or exceptionally strong evidence from observational studiesWeak recommendation, best action may differ depending on the patient, treatment circumstances, or social values
2C
 Weak recommendation, Low-quality or very low-quality evidenceUncertainty in the estimates of benefits, risks, and burden; benefits, risk, and burden may be closely balancedObservational studies or case seriesVery weak recommendation; alternative treatments may be equally reasonable and merit consideration