Cardio-oncology & other

2024 Revision of the level of evidence grading system for ESC clinical practice guideline recommendations I: therapy and prevention

Eur Heart JPublished Scientific statement

Recommendations

As issued by the authors

  1. A

    Conclusive evidence usually from ≥2 adequately powered randomized controlled trials (RCTs) free from major bias, with substantial evidence against the play of chance when combined in a meta-analysis (e.g. P < .005 for superiority); additional criteria for non-inferiority, equivalence and harm

  2. B1

    Suggestive evidence usually from ≥1 adequately powered RCT free from major bias, or a meta-analysis of such RCTs, with some evidence against the play of chance (e.g. P < .05 for superiority)

  3. B2

    Limited evidence from ≥2 adequately powered non-randomised studies with careful control of major sources of bias or from a meta-analysis of small, underpowered RCTs

  4. C

    Preliminary evidence from non-randomised studies without careful control of major sources of bias, a single small, underpowered RCT, or expert consensus

Original publication

2024 Revision of the level of evidence grading system for ESC clinical practice guideline recommendations I: therapy and prevention. Eur Heart J. Published 21 March 2025. doi:10.1093/eurheartj/ehaf009

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