Report in English with a Dutch summary (KCE reports 63A)
Report in English with a Dutch summary (KCE reports 63A)
Report in English with a Dutch summary (KCE reports 63A)
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50 Breast Cancer <strong>KCE</strong> <strong>reports</strong> 63<br />
6 APPENDICES<br />
APPENDIX 1<br />
GRADE SYSTEM<br />
Grade of Recommendation/ Benefit vs. Risk and Burdens Methodological Quality of<br />
Implications<br />
Description<br />
Support<strong>in</strong>g Evidence<br />
1A/ Strong recommendation, high Benefits clearly outweigh risk and RCTs <strong>with</strong>out important limitations or Strong recommendation, can apply to<br />
quality evidence<br />
burdens, or vice versa<br />
overwhelm<strong>in</strong>g evidence from observational most patients <strong>in</strong> most circumstances<br />
studies<br />
<strong>with</strong>out reservation<br />
1B/ Strong recommendation, moderate Benefits clearly outweigh risk and RCTs <strong>with</strong> important limitations<br />
Strong recommendation, can apply to<br />
quality evidence<br />
burdens, or vice versa<br />
(<strong>in</strong>consistent results, methodological flaws, most patients <strong>in</strong> most circumstances<br />
<strong>in</strong>direct, or imprecise) or exceptionally<br />
strong evidence from observational studies<br />
<strong>with</strong>out reservation<br />
1C/ Strong recommendation, low Benefits clearly outweigh risk and Observational studies or case series Strong recommendation, but may change<br />
quality evidence<br />
burdens, or vice versa<br />
when higher quality evidence becomes<br />
available<br />
2A/ Weak recommendation, high Benefits closely balanced <strong>with</strong> risks and RCTs <strong>with</strong>out important limitations or Weak recommendation, best action may<br />
quality evidence<br />
burden<br />
overwhelm<strong>in</strong>g evidence from observational differ depend<strong>in</strong>g on circumstances or<br />
studies<br />
patients’ or societal values<br />
2B/ Weak recommendation, moderate Benefits closely balanced <strong>with</strong> risks and RCTs <strong>with</strong> important limitations<br />
Weak recommendation, best action may<br />
quality evidence<br />
burden<br />
(<strong>in</strong>consistent results, methodological flaws, differ depend<strong>in</strong>g on circumstances or<br />
<strong>in</strong>direct, or imprecise) or exceptionally<br />
strong evidence from observational studies<br />
patients’ or societal values<br />
2C/ Weak recommendation, low quality Benefits closely balanced <strong>with</strong> risks and Observational studies or case series Very weak recommendation, other<br />
evidence<br />
burden<br />
alternatives may be equally reasonable
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