ESC Guidelines Classification Scheme
The Class designation is used to indicate whether a therapy is recommended or not and the certainty surrounding that recommendation.
Classes of Recommendation
Conditions for which there is evidence and/or general agreement that a given procedure or treatment is beneficial, useful, and effective.
Conditions for which there is conflicting evidence and/or a divergence of opinion about the usefulness/efficacy of a procedure or treatment.
Weight of evidence/opinion is in favor of usefulness/efficacy.
Usefulness/efficacy is less well established by evidence/opinion.
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.
Level Of Evidence
Level of Evidence A:
Data derived from multiple randomized clinical trials or meta-analyses of such studies.
Level of Evidence B:
- Data derived from one or more randomized trials or meta-analysis of such studies.
- Data derived from one or more non-randomized trials or meta-analysis of such studies.
Level of Evidence C:
- Non randomized observational studies with limitations in design or execution or Metanalysis of such studies.
- Consensus opinion of experts based on clinical experience.
Applying Classification of Recommendations and Level of Evidence
2016 Classification of Recommendations and Level of Evidence
- Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ; et al. (2016). "2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC". Eur Heart J. 37 (27): 2129–200. doi:10.1093/eurheartj/ehw128. PMID 27206819.