Evidence matrix	Excellent [A]	Good [B]	Satisfactory [C]	Poor [D]
Evidence base	One or more level I studies with a low risk of bias or several level II studies with a low risk of bias.	One- or two-level II studies with a low risk of bias or a SR/several level III studies with a low risk of bias.	One- or two-level III studies with a low risk of bias, or level I or II studies with a moderate risk of bias.	Level IV studies, or level I to III studies/SRs with a high risk of bias.
Consistency	All studies consistent.	Most studies consistent and inconsistency may be explained.	Some inconsistency reflecting genuine uncertainty around clinical question.	Evidence is inconsistent.
Clinical impact	Very large	Substantial	Moderate	Slight or restricted
Generalizability	Population/s studied in body of evidence are the same as the target population for the guideline.	Population/s studied in the body of evidence are similar to the target population for the guideline.	Population/s studied in body of evidence differ to target population for guideline but it is clinically sensible to apply this evidence to target population.	Population/s studied in body of evidence differ to target population and hard to judge whether it is sensible to generalize to target population.
Applicability	Directly applicable to Saudi healthcare context	Applicable to Saudi healthcare context with few caveats	Probably applicable to Saudi healthcare context with some caveats	Not applicable to Saudi healthcare context