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Table 1 Recommendation grading (according to the French National Health Authority, 2010 [28])

From: French good practice guidelines for medical and occupational surveillance of the low back pain risk among workers exposed to manual handling of loads

Level of scientific proof provided by the literature (for clinical studies) Recommendation grading
Level 1 Level A
- High-power randomised comparative studies Scientific proof established
- Meta-analysis of randomised comparative studies
- Decision analysis based on well-conducted studies
Level 2 Level B
- Low-power randomised comparative studies Scientific proof presumed
- Well-conducted non-randomised comparative studies
Level 3 Level C
- Case–control studies Low level of proof
Level 4 Level D
- Comparative studies with major bias Expert consensus
- Retrospective studies
- Case series
  1. In the absence of studies, guidelines are based on a consensus between working party experts after consulting the peer review group