ACC AHA guidelines classification scheme

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The Class designation is used to indicate whether a therapy is recommended or not and the certainty surrounding that recommendation.

Classification of Recommendations

Class I: Benefit >>> Risk

Conditions for which there is evidence and/or general agreement that a given procedure or treatment is beneficial, useful, and effective.

Class II:

Conditions for which there is conflicting evidence and/or a divergence of opinion about the usefulness/efficacy of a procedure or treatment.

Class IIa: Benefit >> Risk

Weight of evidence/opinion is in favor of usefulness/efficacy.

Class IIb: Benefit ≥ Risk

Usefulness/efficacy is less well established by evidence/opinion.

Class III

Conditions for which there is evidence and/or general agreement that a procedure/treatment is not useful/effective and in some cases may be harmful.

Class III: No Benefit

Is not recommended, not indicated, should not be performed/ administered/ other. Is not useful/beneficial/effective.

Class III: Harm

Potentially harmful, causes harm, associated with excess morbidity/mortality. Should not be performed/administered/other.

Use the Level of Evidence designation to indicate the strength of the data associated with that recommendation.

Level of Evidence

Level of Evidence A:

Data derived from multiple randomized clinical trials or meta-analyses of such studies.

Level of Evidence B:

Level of Evidence B-R: Data derived from one or more randomized trials or meta-analysis of such studies.
Level of Evidence B-NR: Data derived from one or more non-randomized trials or meta-analysis of such studies.

Level of Evidence C:

Level of Evidence C-LD:: Non randomized observational studies with limitations in design or execution or Metanalysis of such studies.
Level of Evidence C-EO: Consensus opinion of experts based on clinical experience.

Applying Classification of Recommendations and Level of Evidence

2016 Classification of Recommendations and Level of Evidence

2014 Classification of Recommendations and Level of Evidence


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