Grade recommendation strength and evidence quality definitions

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Grade recommendation strength and evidence quality definitions

Table 1. GRADE recommendation strength and evidence quality definitions.

GDC = Guideline Development Committee; GAG = Guideline Advisory Group. Reproduced from the GRADE Handbook. For further detail, refer to the guideline report methodology section. High quality= no downgrades, or observational evidence* with ≥2 upgrades; moderate quality= one downgrade, or observational evidence* with 1 upgrade; low quality= two downgrades, or observational evidence* with no upgrades; very low quality= ≥3 downgrades, or observational evidence* with ≥1 downgrade.  *For topics where RCT evidence was sought, observational evidence is downgraded to low quality at the outset.  aOnly for observational evidence without downgrades for the subsequent five domains.

1. GRADE handbook for grading quality of evidence and strength of recommendations: The GRADE Working Group; 2013. Available from: guidelinedevelopment.org/handbook.

2.  PREDICT. Australasian Bronchiolitis Guideline: 2025 Update. Melbourne, VIC, Australia; 2025.