Table 2.

Definitions for practice recommendations based on classification of evidence

RecommendationDescription
StandardPrinciple for patient management that reflects a high degree of clinical certainty (usually this requires Class I evidence that directly addresses the clinical question, or overwhelming Class II evidence when circumstances preclude randomized clinical trials).
GuidelineRecommendation for patient management that reflects moderate clinical certainty (usually this requires Class II evidence or a strong consensus of Class III evidence).
Practice OptionStrategy for patient management for which the clinical utility is uncertain (inconclusive or conflicting evidence or opinion).
Practice AdvisoryPractice recommendation for emerging and/or newly approved therapies or technologies based on evidence from at least one Class I study. The evidence may demonstrate only a modest statistical effect or limited (partial) clinical response, or significant cost–benefit questions may exist. Substantial (or potential) disagreement among practitioners or between payers and practitioners may exist.