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Levels of Evidence, Levels of Recommendation

Levels of Evidence, Levels of Recommendation

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1. Levels of Evidence

Type
1a At least one systematic review based on methodologically sound randomized controlled trials (RCTs)
1b At least one sufficiently large, methodologically sound RCT
2a At least one high-quality non-randomized study, e.g., a cohort study
2b At least one high-quality study of another type of quasi-experimental study
3 At least one methodologically sound non-experimental study
4 Opinions and beliefs of respected authorities based on clinical experience, expert committees, and descriptive studies. This also includes prescribing information, FDA labels, guidelines, textbooks, and narrative reviews.

Source: Mehrholz (2010): Science Explained: Levels of Evidence—Classifying Studies by Quality,** Ergopraxis 2010; 3(6): 14
DOI: 10.1055/s-0030-1255425
https://www.thieme-connect.de/products/ejournals/html/10.1055/s-0030-1255425

2. Levels of Recommendation

Level ’s Recommendation
A high- , high-quality body of literature that includes at least one randomized trial with evidence levels Ia or Ib
B A body of evidence comprising well-conducted, non-randomized clinical trials with evidence levels IIa, IIb, or III
C The evidence base includes reports and opinions from experts or clinical experiences from recognized authorities, which are classified as Level IV evidence. However, there is a lack of directly applicable, high-quality clinical studies.

Source: Mehrholz (2010): Science Explained: Levels of Evidence—Classifying Studies According to Their Quality,** Ergopraxis 2010; 3(6): 14
DOI: 10.1055/s-0030-1255425
https://www.thieme-connect.de/products/ejournals/html/10.1055/s-0030-1255425