Introduction: Standards of Medical Care in Diabetes—2019

Introduction

Diabetes Care 2019 Jan; 42(Supplement 1): S1-S2. https://doi.org/10.2337/dc19-Sint01

Article Figures & Tables

Table 1

ADA evidence-grading system for “Standards of Medical Care in Diabetes”

Level of evidence	Description
A	Clear evidence from well-conducted, generalizable randomized controlled trials that are adequately powered, including
	• Evidence from a well-conducted multicenter trial
	• Evidence from a meta-analysis that incorporated quality ratings in the analysis
	Compelling nonexperimental evidence, i.e., “all or none” rule developed by the Centre for Evidence-Based Medicine at the University of Oxford
	Supportive evidence from well-conducted randomized controlled trials that are adequately powered, including
	• Evidence from a well-conducted trial at one or more institutions
	• Evidence from a meta-analysis that incorporated quality ratings in the analysis
B	Supportive evidence from well-conducted cohort studies
	• Evidence from a well-conducted prospective cohort study or registry
	• Evidence from a well-conducted meta-analysis of cohort studies
	Supportive evidence from a well-conducted case-control study
C	Supportive evidence from poorly controlled or uncontrolled studies
	• Evidence from randomized clinical trials with one or more major or three or more minor methodological flaws that could invalidate the results
	• Evidence from observational studies with high potential for bias (such as case series with comparison with historical controls)
	• Evidence from case series or case reports Conflicting evidence with the weight of evidence supporting the recommendation
E	Expert consensus or clinical experience