American Journal of Gastroenterology

TABLE 1

FROM:

ACG Clinical Guidelines: Diagnosis and Management of Celiac Disease

Alberto Rubio-Tapia, Ivor D Hill, Ciarán P Kelly, Audrey H Calderwood and Joseph A Murray

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Table 1. Criteria for assigning grade of evidence

Type of evidence
Randomized trial=high
Observational study=low
Any other evidence=very low
Decrease grade if
Serious (−1) or very serious (−2) limitation to study quality
Important inconsistency (−1)
Some (−1) or major (−2) uncertainty about directness
Imprecise or sparse data (−1)
High probability of reporting bias (−1)
Increase grade if
Strong evidence of association—significant relative risk of >2 (<0.5) based on consistent evidence from two or more observational studies, with no plausible confounders (+1)
Very strong evidence of association—significant relative risk of >5 (<0.2) based on direct evidence with no major threats to validity (+2)
Evidence of a dose–response gradient (+1)
All plausible confounders would have reduced the effect (+1)
Definition of grades of evidence
High=Further research is unlikely to change our confidence in the estimate of effect
Moderate=Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate
Low=Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate
Very low=Any estimate of effect is very uncertain

 Reprinted with permission from Camilleri et al. (264).

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