Grading system
The current guideline has been developed in accordance
with the American Association of Clinical Endocrinologists
protocol for standardized production of clinical practice
guidelines. Recommendations are organized by topic and are
assigned evidence level (EL) ratings on the basis of the quality
of supporting evidence all of which have also been rated for
strength. Recommendations are based on clinical importance
and graded as A (strongly recommend), B (intermediate), C
(weak) and D (not evidence based); The evidence levels are
coupled by 4 intuitive levels of evidence: 1,2,3,4 and they have
been positioned on the basis of available evidence to be used for
grading recommendations as follows.