Whether a statin is indicated, how hard to push it, and which tests would settle it.
Supports Contradicts Complicates Trial still runningBigger circle = more evidence weight. Dashed circle = this app's own rule.
How to read Class and Level
Every guideline recommendation carries two separate grades. The Class says how strongly it is recommended. The Level says how good the evidence behind it is. They are independent: a recommendation can be strong on weak evidence, or weak on strong evidence. ACC/AHA and the ESC use different scales, so they are shown side by side and never converted.
ACC/AHA
Class 1Strong. Benefit far outweighs risk. Worded as "is recommended".
Class 2aModerate. Benefit outweighs risk. Worded as "is reasonable" or "can be useful".
Class 2bWeak. Benefit is about equal to or greater than risk. Worded as "may be considered".
Class 3: No BenefitBenefit equals risk. Worded as "is not recommended".
Class 3: HarmStrong. Risk outweighs benefit. Worded as "potentially harmful".
Level AHigh-quality evidence from more than one randomized trial, meta-analyses of high-quality trials, or trials corroborated by high-quality registries.
Level B-RModerate-quality evidence from one or more randomized trials, or meta-analyses of them.
Level B-NRModerate-quality evidence from well-designed nonrandomized, observational or registry studies, or meta-analyses of them.
Level C-LDLimited data: observational or registry studies with design limitations, or physiological and mechanistic studies in people.
Level C-EOConsensus of expert opinion based on clinical experience.
ESC
Class IEvidence and general agreement that it is beneficial, useful and effective. Worded as "is recommended".
Class IIaWeight of evidence or opinion favors usefulness. Worded as "should be considered".
Class IIbUsefulness is less well established. Worded as "may be considered".
Class IIIEvidence or agreement that it is not useful or effective, and may be harmful. Worded as "is not recommended".
Level AData from multiple randomized trials or meta-analyses.
Level BData from a single randomized trial or large nonrandomized studies.
Level CExpert consensus, small or retrospective studies, or registries.
Tap a claim, a rule, a trial, or a piece of evidence to see how it's connected and what backs it.