2.10.2. Recommendation Grade

The level of recommendation was determined by the magnitude of the benefit or harm. Based on the level of evidence, focusing on the level of confidence in the effect, comparison between the desired and unwanted effects, reliability of values and preferences, and use of resources was conducted.

When the benefit outweighs the harm, the use of the intervention is recommended and the recommendation grade A is assigned. According to the degree, grades B, C, and D are assigned separately.

If the CTB level of evidence is derived based on the textbook of KM prescribed by the Ministry of Health and Welfare and the Ministry of Food and Drug Safety and textbooks of the KM College, the utilization in the clinical field is evaluated and the Good Practice Point (GPP) grade was assigned through the expert consensus process of the development committee. An external consensus was conducted using the Delphi technique. The definitions and notations of the recommendation grades are summarized in Table 2.

**Table 2.** GRADE definitions and notations.

