Interpretation of the Grading of Recommendations Assessment, Development and Evaluation (GRADE)
| Interpretation of strong and conditional (weak) recommendations | Strong recommendation | Conditional (weak) recommendation* |
| For patients | Most individuals in this situation would want the recommended course of action and only a small proportion would not. | The majority of individuals in this situation would want the suggested course of action, but many would not. |
| For clinicians | Most individuals should receive the intervention. Formal decision aids are not likely to be needed to help individuals make decisions consistent with their values and preferences. | Recognise that different choices will be appropriate for individual patients and that clinicians must help each patient arrive at a management decision consistent with his or her values and preferences. Decision aids may be useful in helping individuals making decisions consistent with their values and preferences. |
| For policy makers and developers of quality measure | The recommendation can be adapted as policy in most situations. Adherence to this recommendation according to the guideline could be used as a quality criterion or performance indicator. | Policy making will require substantial debate and involvement of various stakeholders. An appropriately documented decision making process could be used as quality indicator. |
| Interpretation of the categories of the quality of evidence | ||
| High: ⊕⊕⊕⊕ | There is high confidence that the true effect lies close to that of the estimate of the effect. | |
| Moderate: ⊕⊕⊕○ | There is moderate confidence in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. | |
| Low: ⊕⊕○○ | The panel's confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. | |
| Very low: ⊕○○○ | There is little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | |
↵* Guideline panels applying GRADE use the terms ‘conditional’ and ‘weak’ synonymously.