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Table 3 Details on the certainty of evidence ratings including down- and upgrading’s of the evidence according to study design

From: A methodologic survey on use of the GRADE approach in evidence syntheses published in high-impact factor urology and nephrology journals

  Total (%) RCTs (%) NRSs (%) RCTs/NRSs (%)
The rating of the certainty per outcome, n 811 544 256 11 (5 studies)
 High, n (%) 84 (10.4) 83 (15.3) 1 (0.4) 0
 Moderate, n (%) 199 (24.5) 151 (27.7) 45 (17.6) 3 (27.3)
 Low, n (%) 260 (32.1) 185 (34.0) 69 (27.0) 6 (54.5)
 Very low, n (%) 268 (33.0) 125 (23.0) 141 (55.0) 2 (18.2)
Total number of downgrading domains, n 1012 667 339 6
 Risk of bias, n (%) 528 (52.2) 358 (53.8) 167 (49.3) 3 (50.0)
 Imprecision, n (%) 278 (27.5) 207 (31.0) 71 (21.0) 0
 Inconsistency, n (%) 146 (14.4) 84 (12.6) 60 (17.7) 2 (33.3)
 Indirectness, n (%) 55 (5.4) 17 (2.5) 37 (10.8) 1 (16.7)
 Publication bias, n (%) 5 (0.5) 1 (0.1) 4 (1.2) 0
Upgradings, n 21 0 19 2
 Large effect, n (%) 3 (14.3) 0 1 (5.3) 2 (100.0)
 Dose–response, n (%) 10 (47.6) 0 10 (52.6) 0
 Plausible confounding, n (%) 8 (38.1) 0 8 (42.1) 0
Frequency of the rating domains
Mean frequency, n of Downgradings domains, n / The rating of the certainty per outcome, n 1.25
1012/811
1.23
667/544
1.32
339/256
0.55
6/11
  Risk of bias, n (% of outcomes downgraded) 528 (65.1) 358 (65.8) 167 (65.2) 3 (27.3)
  Imprecision, n (% of outcomes downgraded) 278 (34.3) 207 (38.0) 71 (27.7) 0
  Inconsistency, n (% of outcomes downgraded) 146 (18.0) 84 (15.4) 60 (23.4) 2 (18.2)
  Indirectness, n (% of outcomes downgraded) 55 (6.8) 17 (3.1) 37 (14.5) 1 (9.1)
  Publication bias, n (% of outcomes downgraded) 5 (0.6) 1 (0.2) 4 (1.6) 0
 Mean frequency, n of Upgrading domains, n / The rating of the certainty per outcome, n 0.03
21/811
0.00
0/544
0.07
19/256
0.18
2/11
  Large effect, n (% of outcomes upgraded) 3 (0.4) 0 1 (0.4) 2 (18.2)
  Dose–response, n (% of outcomes upgraded) 10 (1.2) 0 10 (3.9) 0
  Plausible confounding, n (% of outcomes upgraded) 8 (1.0) 0 8 (3.1) 0
  1. RCTs Randomized controlled trials, SRs Systematic reviews