FORM: An Australian method for formulating and grading recommendations in evidence-based clinical guidelines

Table 1 NHMRC Body of evidence matrix

Component	A Excellent	B Good	C Satisfactory	D Poor
Evidence base¹	One or more level I studies with a low risk of bias or several level II studies with a low risk of bias	One or two level II studies with a low risk of bias or an SR/several level III studies with a low risk of bias	One or two level III studies with a low risk of bias, or level I or II studies with a moderate risk of bias	Level IV studies, or level 1 to II studies/SRs with a high risk of bias
Consistency²	All studies consistent	Most studies consistent and inconsistency may be explained	Some inconsistency reflecting genuine uncertainty around clinical question	Evidence is consistent
Clinical impact	Very large	Substantial	Moderate	Slight or restricted
Generalisability	Population/s studied in body of evidence are the same as the target population in the guideline	Population/s studied in the body of evidence are similar to the target population for the guideline	Population/s studied in the body of evidence differ to the target population guideline but it is clinically sensible to apply this evidence to the target population³	Population/s studied in the body of evidence differ to the target population and hard to judge whether it is sensible to generalize to target population
Applicability	Directly applicable to Australian healthcare context	Applicable to Australian health care context with few caveats	Probably applicable Australian healthcare context with some caveats	Not applicable to Australian healthcare context

SR = systematic review; several = more than two studies
¹ Level of evidence determined from the NHMRC Evidence Hierarchy
² If there is only one study, rank this component as 'not applicable'
³ For example, results in adults that are clinically sensible to apply to children OR psychosocial outcomes for one cancer that may be applicable to patients with another cancer

ISSN: 1471-2288