ELCA Class of Recommendation
There is no "ELCA" (European League Against Cancer) class of recommendation system in medical practice—this appears to be a confusion with "ELCWP" (European Lung Cancer Working Party) or other established grading systems like GRADE, which are actually used in clinical guidelines. 1
Clarification of Terminology
The question references "ELCA" which does not exist as a guideline grading organization. The evidence reveals:
- ELCWP (European Lung Cancer Working Party) developed recommendations for lung cancer using the GRADE system for grading evidence and recommendations 1
- ELCWP is not a grading system itself—it is a working party that adopted the internationally recognized GRADE methodology 1
The GRADE System Used by ELCWP
The ELCWP explicitly states they "have chosen the GRADE system" for grading their guidelines, which is an internationally accepted grading system previously used by the American College of Chest Physicians for lung cancer 1
GRADE Evidence Quality Levels:
- High quality (A): Further research very unlikely to change confidence in the estimate of effect 1
- Moderate quality (B): Further research likely to have important impact on confidence and may change the estimate 1
- Low/Very low quality (C): Further research very likely to have important impact and likely to change the estimate; any estimate is uncertain 1
GRADE Recommendation Strength:
- Strong recommendation (1): Quality of evidence, presumed patient-important outcomes, and cost support strong recommendation 1
- Weak recommendation (2): Variability in preferences/values, uncertainty, higher cost, or resource consumption warrant weaker recommendation 1
Key Advantages of GRADE
GRADE allows integration of both objective scientific evidence quality and subjective variables including balance between desirable/undesirable effects, patient values and preferences, and costs—factors important in routine practice but not always derivable from literature alone 1
Common Pitfall
Do not confuse organizational acronyms (ELCWP, EASL, ESMO, ILCA) with grading systems (GRADE)—these organizations adopt GRADE but are not grading systems themselves 1