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Table 1 Grading of Recommendation from Guyatt et al. [67] (GRADE)

From: A systematic review on the use of topical hemostats in trauma and emergency surgery

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

Strong recommendation, applies to most patients in most circumstances without reservation

1B. Strong recommendation, moderate-quality evidence

Benefits clearly outweigh risk and burdens, or vice versa

RCTs with important limitations (inconsistent results, methodological flaws, indirect analyses or imprecise conclusions) or exceptionally strong evidence from observational studies

Strong recommendation, applies to most patients in most circumstances without reservation

1C. Strong recommendation, low-quality or very low-quality evidence

Benefits clearly outweigh risk and burdens, and vice versa

Observational studies or case series

Strong recommendation but subject to change when higher-quality evidence becomes available

2A. Weak recommendation, moderate-quality evidence

Benefits closely balanced with risks and burdens

RCTs without important limitations or overwhelming evidence from observational studies

Weak recommendation, best action may differ depending on the patient, treatment circumstances, or social values

2B. Weak recommendation, moderate-quality evidence

Benefits closely balanced with risks and burdens

RCTs with important limitations (inconsistent results, methodological flaws, indirect analyses or imprecise conclusions) or exceptionally strong evidence from observational studies

Weak recommendation, best action may differ depending on the patient, treatment circumstances, or social values

2C. Weak recommendation, low-quality or very low-quality evidence

Uncertainty in the estimates of benefits, risks, and burdens; benefits, risks, and burdens may be closely balanced

Observational studies or case series

Very weak recommendation, alternative treatments may be equally reasonable and merit consideration