SMART Base
0.3.0 - ci-build

SMART Base, published by WHO. This guide is not an authorized publication; it is the continuous build for version 0.3.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/litlfred/smart-base/ and changes regularly. See the Directory of published versions

CodeSystem: Knowledge graph: GRADE recommendation strength

Official URL: http://smart.who.int/base/CodeSystem/KGGradeStrength Version: 0.3.0
Active as of 2026-10-06 Computable Name: KGGradeStrength

How strongly a recommendation is made. Strength is NOT certainty: a strong recommendation can rest on low-certainty evidence and a conditional one on high certainty. Moved from smart-kg/methodologies/grade.md by bean wg7r, 2026-09-24 (owner: 'needs to be part of skill/SKOS'). Read with the grade skill. Source: folio-assistant cat-harness/code-lists/grade-recommendation-strength.json (bean wg7r), codes and definitions verbatim; Andrews JC, et al. GRADE guidelines: 15. Going from evidence to recommendation — determinants of a recommendation's direction and strength. J Clin Epidemiol 2013;66(7):726-735; WHO Handbook for Guideline Development, 2nd ed. (2014), which uses 'conditional' for GRADE's 'weak' https://doi.org/10.1016/j.jclinepi.2013.02.003.

This Code system is referenced in the content logical definition of the following value sets:

This case-sensitive code system http://smart.who.int/base/CodeSystem/KGGradeStrength defines the following codes:

CodeDisplayDefinition
strong Strong The guideline panel is confident that the desirable effects of following the recommendation clearly outweigh the undesirable effects — or clearly do not, for a recommendation against — so most informed people would choose the recommended course.
conditional Conditional The desirable effects probably outweigh the undesirable effects, but the panel is less confident: the balance is close, the evidence uncertain, or values and preferences vary, so different choices will suit different people or settings. GRADE's 'weak'; WHO uses 'conditional'.