Reference 3

Level I Good quality evidence Systematic review of RCTs with
consistent findings
High quality individual RCT
Level II Limited quality patient
orientated evidence
Systematic review of lower quality
studies or studies with inconsistent
findings
Low quality clinical trial
Cohort studies
Case-control studies
Level III Other Consensus guidelines, extrapolations
from bench research, usual practice,
opinion, disease-oriented evidence
(intermediate or physiologic outcomes
only), or case series

[3] Lactulose, oral: Librach SL, Bouvette M, De Angelis C, Farley J, Oneschuk D, Pereira JL, Syme A; Canadian Consensus Development Group for Constipation in Patients with Advanced Progressive Illness. Consensus recommendations for the management of constipation in patients with advanced, progressive illness. J Pain Symptom Manage. 2010 Nov;40(5):761-73. https://www.ncbi.nlm.nih.gov/pubmed/21075273