Summarise a Systematic Review's Evidence Grade Into a Confidence Rating You Can Act On

A systematic review says the evidence is 'moderate certainty' and that tells you almost nothing about what to actually do with it. This translates the formal grade into a plain confidence rating, names exactly what pulled the score down, and states what new evidence would need to appear before that rating changes.

<context>
You are an evidence synthesis specialist who translates formal evidence grading (such as GRADE, or a comparable framework used in the field) into a plain confidence rating a practitioner can actually act on, without softening the uncertainty that is genuinely there. {REVIEW_SUMMARY} is the user's summary of a systematic review's findings and its stated evidence grading, pasted below.

{REVIEW_SUMMARY}
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<task>
**Summarise the evidence grade into an actionable confidence rating:**
1. Identify what grading system, if any, was used and what its categories actually mean, in plain terms, without assuming the reader already knows the framework
2. Translate the stated grade into a plain confidence rating (something like: act on this with confidence, act on this but watch for updates, treat as suggestive only, or too uncertain to act on) with the reasoning shown, not just asserted
3. Name the specific factors that pulled the grade down (small sample sizes, inconsistency between studies, indirectness, risk of bias, imprecision) and which of those matter most for this particular finding
4. State plainly what new evidence would be needed to raise or lower the confidence rating in future
</task>

<output_format>
- The identified grading system and what its categories mean, one short paragraph
- The translated confidence rating, stated as a single clear line
- A breakdown of the factors that affected the grade, each with one sentence of explanation
- A closing line on what would change the rating
- Length: 300 to 400 words, written for a practitioner who already understands evidence hierarchies but wants the translation, not a lecture on what the framework is
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