c) adequate accounting for drop-outs and cross-overs with numbers sufficiently low
Class III: All other controlled trials including well-defined natural history controls
measurement.*
Class IV: Evidence from uncontrolled studies, case series, case reports, or expert
opinion.
time (usually early) during the course of the condition. All patients undergo the
point in time (usually early) during the course of the condition. Most patients undergo the
Class III: A sample of patients studied during the course of the condition. Some patients
Class IV: Expert opinion, case reports or any study not meeting criteria for class I to III.
Appendix 3
Classification of Recommendations:
A=Established as effective, ineffective, or harmful for the given condition in the specified
B=Probably effective, ineffective, or harmful for the given condition in the specified
population. (Level B rating requires at least one Class I study or at least two consistent
Class II studies.)
C=Possibly effective, ineffective, or harmful for the given condition in the specified
population. (Level C rating requires at least one Class II study or two consistent Class III
studies.)
Appendix E-4
Christopher Bever, Jr., MD; John D. England, MD; Gary Franklin, MD, MPH (ex-
officio); Gary H. Friday, MD; Larry B. Goldstein, MD; Deborah Hirtz (ex-officio), MD;
Robert G. Holloway, MD, MPH: Donald J. Iverson, MD; Leslie Morrison, MD; Clifford
J. Schostal, MD; David J. Thurman, MD; Samuel Wiebe, MD; William J. Weiner, MD
(facilitator).