Part III Intercollegiate exam / How do you grade evidence?

YOU NEED TO KNW THIS

Also see this link http://www.cebm.net/index.aspx?o=1047

Revised grading system for recommendations in evidence based guidelines

Levels of evidence

1++ High quality meta-analyses, systematic reviews of RCTs, or RCTs with a very low risk of bias

1+ Well conducted meta-analyses, systematic reviews of RCTs, or RCTs with a low risk of bias

1 Meta-analyses, systematic reviews or RCTs, or RCTs with a high risk of bias

2++ High quality systematic reviews of case-control or cohort studies or

High quality case-control or cohort studies with a very low risk of confounding, bias, or chance and a high probability that the relationship is causal

2+ Well conducted case-control or cohort studies with a low risk of confounding, bias, or chance and a moderate probability that the relationship is causal

2 Case-control or cohort studies with a high risk of confounding, bias, or chance and a significant risk that the relationship is not causal

3 Non-analytic studies, eg case reports, case series

4 Expert opinion

Grades of recommendations

A At least one meta-analysis, systematic review, or RCT rated as 1++ and directly applicable to the target population or

A systematic review of RCTs or a body of evidence consisting principally of studies rated as 1+ directly applicable to the target population and demonstrating overall consistency of results

B A body of evidence including studies rated as 2++ directly applicable to the target population and demonstrating overall consistency of results or

Extrapolated evidence from studies rated as 1++ or 1+

C A body of evidence including studies rated as 2+ directly applicable to the target population and demonstrating overall consistency of results or

Extrapolated evidence from studies rated as 2++

D Evidence level 3 or 4 or

Extrapolated evidence from studies rated as 2+

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