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How evidence gets graded, and what a recommendation means

How evidence gets graded, and what a recommendation means: this guide has a section for each grading system and per phrase people meet without explanation…

This launch guide maps the topic, the source base and the practical questions. Check the linked official authority before acting on a rule, deadline, price or safety requirement.

What this guide covers

This guide has a section for each grading system and per phrase people meet without explanation: GRADE's four certainty levels and the five reasons a body of evidence gets downgraded, strong vs conditional recommendations, USPSTF grades A to D and I, Cochrane's certainty wording, NICE's "offer / consider" distinction, what an EFSA opinion is, and why "insufficient evidence" is not "shown not to work".

Two further pages show how a guideline is actually assembled and how to find the guideline sitting behind a piece of advice in each country. Fourteen pages, and it is the vocabulary every other page on this site quietly assumes.

How to use it

Use How evidence gets graded, and what a recommendation means as a structured learning path: begin with the vocabulary, follow the evidence map, and keep the uncertainty labels attached to claims as you compare sources.

The page keeps the main question, its evidence base and its limits together in one canonical place. That makes it useful as a quick orientation and avoids splitting a broad subject into shallow pages before each narrower answer has enough verified material of its own.

Search vocabulary in four languages

Terminology changes across borders. These are example phrases people use for the same subject in Estonian, Finnish, Russian and English; they are included as a practical vocabulary aid, not as hidden keywords.

Evidence and provenance

The evidence map below records the primary, official or openly licensed material chosen for this guide. It is deliberately visible so a reader can tell the difference between a rule published by an authority, a measured dataset and an editorial explanation.

Source: own writing; the GRADE Handbook (free), USPSTF grade definitions (US public domain), Cochrane certainty wording and EFSA opinion structure, all cited. · checked 2026-09-09

Source names are preserved even where an authority changes its web address. No figure is added to this launch page unless it is already present in the cited source description or can be computed from a named dataset.

Scope and boundaries

This guide owns the explanatory layer for the topic. Personal decisions, diagnoses, legal determinations and live availability remain with the relevant professional or official service.

Connected TempoLife guides

The following paths are the intentional hand-offs named in the brief. They keep adjacent subjects separate while making the next useful reference easy to find.

Why it belongs on TempoLife

/research, /medcheck, /myths.

Frequently asked questions