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Table 1 American Academy of Pediatrics defined strategy for recommendation development [9]

From: Benefits and harm of systemic steroids for short- and long-term use in rhinitis and rhinosinusitis: an EAACI position paper

Evidence quality Preponderance of benefit over harm Balance of benefit and harm Preponderance of harm over benefit
A. Well-designed RCTs Strong recommendation Option Strong recommendation against
B. RCT’s with minor limitations; overwhelming consistent evidence from observational studies Recommendation
C. Observational studies (case–control and cohort design) Recommendation against
D. Expert opinion; case reports; reasoning from first principles Option No recommendation
  1. RCT randomized controlled trial