Grades of Evidence & Levels of Recommendations: The Basis of EBP

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Grades of Evidence

I: Evidence obtained from at least one properly designed randomized controlled trial.

II-A: Evidence obtained from well-designed controlled trials without randomization.

II-B: Evidence obtained from well-designed cohort or case–control analytic studies, preferably from more than one center or research group.

II-C: Evidence obtained from multiple time series with or without the intervention. Dramatic results in uncontrolled experiments also could be regarded as this type of evidence.

III: Opinions of respected authorities, based on clinical experience, descriptive studies, or reports of expert committees.

Levels of Recommendations

Level A — Recommendations are based on good and consistent scientific evidence.

Level B — Recommendations are based on limited or inconsistent scientific evidence.

Level C — Recommendations are based primarily on consensus and expert opinion.

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