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Evidence quality
Preponderance of benefit over harm
Balance of benefit and harm
Preponderance of harm over benefit
A. Well-designed RCTs
Strong recommendation
Option
Strong recommendation against
B. RCT’s with minor limitations; overwhelming consistent evidence from observational studies
Recommendation
C. Observational studies (case–control and cohort design)
Recommendation against
D. Expert opinion; case reports; reasoning from first principles
