Table 1

Strength of Recommendations Taxonomy20

Strength of RecommendationsDefinition
ARecommendation based on consistent* and good quality† patient-oriented evidence‡
BRecommendation based on inconsistent or limited quality patient-oriented evidence
CRecommendation based on consensus, usual practice, opinion, disease-oriented evidence or case series
  • For a detailed discussion, see

  • *Consistency: most studies found similar or at least coherent conclusions, or high-quality and up-to-date systematic reviews exist and support the recommendation.

  • †Good quality: validated clinical decision rules, meta-analyses of high-quality studies and high-quality individual cohort studies for diagnosis; meta-analyses of RCTs, high-quality individual RCTs and all or none studies for treatment and prevention; and meta-analyses of good quality cohort studies and individual cohort studies with good follow-up for prognosis.

  • ‡Patient-oriented evidence: outcomes that matter to patients, such as morbidity, mortality, symptom improvement, cost reduction and quality of life.

  • RCT, randomised controlled trial.