ACS Workgroup Grading System for Evaluating Benefit Versus Harm
To summarize the strength of the scientific evidence, the ACS Workgroup used a method of summarizing the evidence similar to those used by other expert panels. For example, the US Preventive Services Task Force judged the scientific evidence related to clinical preventive services using a system that considered both the source and strength of the evidence and categorized them as follows:
From at least one controlled clinical trial, from good uncontrolled trials, from multiple good observation studies, expert opinion, and case reports. They then characterized those recommendations on a five-point grading scheme as to the strength of the recommendation: Good for recommending, fair for recommending, insufficient to recommend for or against, fair for not recommending, or good for not recommending.
The AICR-World Cancer Research Fund project summarized the nature of the scientific evidence for nutritional factors in cancer prevention as being either Convincing, Probable, Possible, or Insufficient.
The ACS committee employed a method of summarizing the evidence that was similar to those used by both groups. For each issue, the committee judged the likelihood of benefit to cancer survivors as follows:
A1 Proven benefit
A2 Probable benefit, but unproven
A3 Possible benefit, but unproven
B Insufficient evidence to conclude benefit or risk
C Evidence of possible harm as well as possible benefit
D Evidence of lack of benefit
E Evidence of harm
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