Evidence levels, recommendation levels

1. Increments of evidence

Increment	Type	Max. risk of bias
1++	High-quality meta-analyses, systematic reviews of RCTs or RCTs	Very low risk of bias
1+	Well-conducted meta-analyses, systematic reviews of RCTs or RCTs	Low risk of bias
1	Meta-analyses, systematic reviews of RCTs or RCTs	High risk of bias
2+	Well-conducted case-control or cohort studies	Low risk of confounding, bias or chance and at least a medium probability that the association is causal
2	Case-control or cohort studies	high risk of confounding, bias or chance and at least a significant risk that the association is not causal
3	Non-analytical studies, e.g. case reports, case series
4	Expert opinion

Increment	Recommendation
A	At least one meta-analysis, systematic review or RCT that has been rated 1++ and is directly applicable to the target population;
	or a systematic review of RCTs or a body of evidence consisting primarily of studies that are rated 1+, are directly applicable to the target population, and have overall consistency of results
B	A body of evidence that includes studies that are rated 2++, are directly applicable to the target population, and demonstrate overall agreement of results
	or extrapolated evidence from studies rated 1++ or 1+
C	Body of evidence includes studies rated 2+ that are directly applicable to the target population and whose results are consistent overall
	or extrapolated evidence from studies rated 2++
D	Evidence level 3 or 4
	or extrapolated evidence from studies rated 2+

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