Table 1 The grading of the quality of evidence and the strength of recommendations are here reported together with the graphical descriptions and the terminology used. This methodology was the same used in the referral guideline [3] to harmonize the final document with the regard of the new clinical items analyzed
Certainty of evidence | ||
Graphical descriptions | Grading | Meaning |
⊕◯◯◯ | Very low-quality evidence | Very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect |
⊕⊕◯◯ | Low quality evidence | Limited confidence in the effect estimate: the true effect may be substantially different from the estimate of the effect |
⊕⊕⊕◯ | Moderate quality evidence | Moderate confidence 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 |
⊕⊕⊕⊕ | High quality evidence | Very confidence in the effect estimate: the true effect lies close to that of the estimate of the effect |
Strength of recommendation | ||
Graphical descriptions | Grading | Terminology |
♦ | Conditional recommendation against the option, there is lack of appropriate evidence or harms may outweigh benefits | “should not” |
♦♦ | Conditional recommendation for either the option or the comparison, the quality was limited, and the benefits of the option did not exceed clearly the harms | “could consider” |
♦♦♦ | Conditional recommendation for the option, the quality was limited, and available studies demonstrate little clear advantage of the option in terms of benefits / harms ratio | “should consider” |
♦♦♦♦ | Strong recommendation for the option, the benefits of the option exceed the harms | “should” |
Terminology to categorize the recommendations | Meaning | |
EBR: evidence-based recommendation | The evidence was sufficient to inform a recommendation made, good clinical practice (high quality evidence for every day clinical activity) | |
CR: consensus recommendation | The evidence was not sufficient to inform a recommendation made (or only data from the general population are available), “expert opinion” (option not supported by direct evidence, but potentially useful for the clinical practice) | |
PP: practice point | The evidence from the PCOS and/or general population was not available about important clinical topics and the consensus recommendation was arbitrarily made, “expert opinion” (option not supported by direct evidence, but potentially useful for the clinical practice) | |