Guideline for diagnosis and treatment of subacromial pain syndrome

Figures & data

Table 1. GRADE evidence levels of intervention studies

Evidence level of intervention study (examples)
High	RCTs without severe limitations. Observational studies with very large effects and without severe limitations.
Moderate	RCTs with severe limitations. Observational studies with large effects and without severe limitations.
Low	RCTs with extremely severe limitations. Observational studies without severe limitations.
Very low	RCTs with extremely severe limitations and inconsistent results. Observational studies with severe limitations.Non-systematic clinical observations (e.g. case series and case reports).

Table 2. EBRO evidence levels of diagnostic accuracy research or research into etiology and prognosis

Evidence level	Diagnostic accuracy research	Etiology, prognosis
A1	Meta-analysis of at least 2 independently conducted studies at the A2 level
A2	Research compared to a reference test (gold standard) with previously defined cutoff values and independent evaluation of results, with a sufficiently large series of consecutive patients who have only had the index and reference test.	Prospective cohort study with sufficient size and follow-up and with adequate controlling for “confounding”, and where selective follow-up has been sufficiently ruled out.
B	Research compared to a reference test, but not with all the features listed under A2.	Prospective cohort study but not with all the features listed under A2, retrospective cohort study, or patient-controlled study.
C	Non-comparative study.

Table 3. Level-of-evidence strength of the conclusion, based on the literature underlying the conclusion

Level	Conclusion based on
1	For therapeutic intervention studies: high-quality studies. For diagnostic accuracy research or prognosis, etiology or side effects: A1-level study or at least 2 independently conducted A-2 level studies.
2	For therapeutic intervention studies: moderate-quality studies. For diagnostic accuracy research or prognosis, etiology or side effects: one A2-level study or at least 2 independently conducted B-level studies.
3	For therapeutic intervention studies: low-quality studies. For diagnostic accuracy research or prognosis, etiology or side effects: one B-level study or at least 2 independently conducted C-level studies.
4	For therapeutic intervention studies: very low-quality studies.For diagnostic accuracy research or prognosis, etiology or side effects: one C-level study.