The effectiveness of peer and community health worker-led self-management support programs for improving diabetes health-related outcomes in adults in low- and-middle-income countries: a systematic review

Table 3 Assessment of quality of evidence (GRADE) in the included studies

Study ID	Study design	Study limitation	Inconsistency	Indirectness	Imprecision	Bias	Overall quality
Debussche et al. [50]	RCT	√	√	√	√	√	++++
Zhong et al. [51]	RCT	√	X	√	√	X	+++
Gagliardino et al. [52]	RCT	X	X	√	√	X	++
Mash et al. [53]	RCT	√	X	√	√	X	+++
Assah et al. [43]	Non-RCT with control	X	X	√	√	X	++
Baumann et al. [44]	UCBA (one-group)	X	X	√	√	X	++
Micikas et al. [49]	UCBA (one-group)	√	X	√	X	X	++
Eggermont [45]	UCBA (one-group)	X	X	√	√	X	++
Rotheram-Borus et al. [46]	UCBA (one-group)	X	X	√	√	X	++
Shen [47]	CBA (comparison group)	√	X	√	√	X	++
Less et al. [48]	CBA (comparison group)	√	X	√	√	X	++

√ no serious limitations; X serious limitations, for overall quality of evidence: + very low; ++ low; +++ moderate; ++++ high; RCT randomize control trials; CBA controlled before and after studies; UCBA uncontrolled before and after

ISSN: 2046-4053