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Table 1 Categories of Consistency and Inconsistency

From: The Systematic Guideline Review: Method, rationale, and test on chronic heart failure

Type Definition Further Action Plan for Guideline Development
Consistency
(1) Recommendations are consistent in content, evidence level and grading, and based on a large body of high level evidence (e.g. multiple primary or secondary studies of high internal and external validity) Verification of cited sources with highest evidence level, and update searches, if necessary
(2) Recommendations are consistent in content, evidence level and grading, and based on a small body of high level evidence (e.g. a single or a few primary studies of high internal and external validity) Verification of cited sources, further research on safety aspects in particular, and update searches
(3) Recommendations are consistent in content, evidence level and grading, and based on evidence from studies of low level evidence (e.g. studies with design-related biases or where methodological flaws reduce internal or external validity) or based on expert opinion (where evidence is lacking) Further research on evidence
(4) Recommendations are consistent in content, but evidence levels and grading conflict Verification of cited sources, and update searches
Inconsistency
(A) Recommendations are completely inconsistent, neither a mainstream trend nor even a common denominator can be identified Further research on evidence
(B) Recommendations are consistent in the majority of guidelines, but differing or even conflicting recommendations are to be found in a minority Verification of cited sources to decide whether further research is necessary, and update-searches