Higher quality research may well have an important impact on our con dence in the estimate of effect and may change the estimate Strong recommendation, Low quality evidence Bene ts clearly outweigh risk and burdens, or vice versa Our con dence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect. Recommendation can apply to most patients in many circumstances. Higher quality research is likely to have an important impact on our con dence in the estimate of effect and may well change the estimate Strong recommendation, very low quality evidence Bene ts clearly outweigh risk and burdens, or vice versa We have very little con dence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect Recommendation can apply to most patients in many circumstances. Higher quality research is likely to have an important impact on our con dence in the estimate of effect and may well change the estimate Weak (conditional) recommendation, High quality evidence Bene ts closely balanced with risks and burden We are very con dent that the true effect lies close to that of the estimate of the effect The best action may differ depending on circumstances or patients or societal values. Further research is very unlikely to change our con dence in the estimate of effect Weak (conditional) recommendation, Moderate-quality evidence Bene ts closely balanced with risks and burden We are moderately con dent 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 Best action may differ depending on circumstances or patients or societal values. 