Skip to main content

Table 4 Definition of Grades of Recommendation for action statements

From: Evidence-based guidelines for physiotherapy management of patients with multiple myeloma: study protocol

Grade Recommendation Quality of Evidence
A Strong A preponderance of level I studies, but least 1 level I study directly on the topic support the recommendation.
B Moderate A preponderance of level II studies but at least 1 level II study directly on topic support the recommendation.
C Weak A single level II study at less than 25% critical appraisal score or a preponderance of level III and IV studies, including statements of consensus by content experts support the recommendation.
D Theoretical/foundational A preponderance of evidence from animal or cadaver studies, from conceptual/theoretical models/principles, or from basic science/bench research, or published expert opinion in peer-reviewed journals supports the recommendation.
P Best practice Recommended practice based on current clinical practice norms, exceptional situations where validating studies have not or cannot be performed and there is a clear benefit, harm, or cost, and/or the clinical experience of the guideline development group.
R Research There is an absence of research on the topic, or higher-quality studies conducted on the topic disagree with respect to their conclusions. The recommendation is based on these conflicting or absent studies.
  1. Reprinted from Kaplan SL, Coulter C, Fetters L. Developing evidence-based physical therapy clinical practice guidelines. Pediatr Phys Ther. 2013;25:257–270, with permission of Wolters Kluwer Health Inc.