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Table 2 Grading of Recommendations, Assessment, Development and Evaluation (GRADE). RCTs randomized controlled trials

From: Intraoperative surgical site infection control and prevention: a position paper and future addendum to WSES intra-abdominal infections guidelines

Grade of recommendation Quality of supporting evidence Implications
1A Strong recommendation, high-quality evidence RCTs without important limitations or overwhelming evidence from observational studies Strong recommendation, applies to most patients in most circumstances without reservation
1B Strong recommendation, moderate-quality evidence RCTs with important limitations (inconsistent results, methodological flaws, indirect analyses or imprecise conclusions) or exceptionally strong evidence from observational studies Strong recommendation, applies to most patients in most circumstances without reservation
1C Strong recommendation low-quality or very low-quality evidence Observational studies or case series Strong recommendation but subject to change when higher quality evidence becomes available
2A Weak recommendation high-quality evidence RCTs without important limitations or overwhelming evidence from observational studies Weak recommendation, the best action may differ depending on the patient, treatment circumstances, or social values
2B Weak recommendation moderate-quality evidence RCTs with important limitations (inconsistent results, methodological flaws, indirect or imprecise) or exceptionally strong evidence from observational studies Weak recommendation, the best action may differ depending on the patient, treatment circumstances, or social values
2C Weak recommendation low-quality or very low-quality evidence Observational studies or case series Very weak recommendation; alternative treatments may be equally reasonable and merit consideration