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Table 1 ACCP classification criteria for grading evidence in clinical guideline [13]

From: Frostbite: a practical approach to hospital management

Grade Description Benefits vs. risks and burdens Methodological quality of supporting evidence
1A Strong recommendation, high-quality evidence Benefits clearly outweigh risks and burdens or vice versa RCTs without important limitations or overwhelming evidence from observational studies
1B Strong recommendation, moderate-quality evidence Benefits clearly outweigh risks and burdens or vice versa RCTs with important limitations or exceptionally strong evidence from observational studies
1C Strong recommendation, low-quality or very low-quality evidence Benefits clearly outweigh risks and burdens or vice versa Observational studies or case series
2A Weak recommendation, high-quality evidence Benefits closely balanced with risks and burdens RCTs without important limitations or overwhelming evidence from observational studies
2B Weak recommendation, moderate-quality evidence Benefits closely balanced with risks and burdens RCTs with important limitations or exceptionally strong evidence from observational studies
2C Weak recommendation, low-quality or very low-quality evidence Uncertainty in the estimates of benefits, risks and burden; benefits, risk and burden may be closely balanced Observational studies or case series
  1. RCT, randomized controlled trial.