Explanation of strength of recommendations
The Guideline Development Group provided a judgement on the strength of each recommendation to be categorized as "STRONG" or "STANDARD". Determinants of the strength of recommendation included the quality of the evidence, the balance between desirable and undesirable effects, values, preferences and feasibility issues.
A “STRONG” recommendation is one for which the guideline development group is confident that most patients should receive the recommended course of action, and policy makers can easily adapt the recommendation as policy in most situations.
A “STANDARD” recommendation is one for which the guideline development group is confident that the recommended course of action may be offered for the majority of patients, but this may not be applicable for many patients. Policy makers can use standard recommendations as a starting point for further discussions with the stakeholders before deciding to include them in the adapted versions.