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Table 3 Summary of findings of included studies using the GRADE methodology (Grading of Recommendations Assessment, Development and Evaluation)

From: Factors associated with antiretroviral treatment failure among people living with HIV on antiretroviral therapy in resource-poor settings: a systematic review and metaanalysis

Factors assessed

Number of studies (SD)

Main findings

Strength of evidence (high, moderate, low, very low)

Adherence (poor versus good)

6 (cross-sectional)

Odds ratio: 5.90 (95%CI, 3.50–9.94)

Moderatea

Adherence (poor versus good)

4 (cohort studies)

Hazar ratio: 2.46 (95% CI, 1.72–3.51)

High

CD4 cell count (< 200 versus ≥ 200 cells/mm3)

3 (cross-sectional)

Odd ratio: 4.82 (95% CI, 2.44–9.52)

Lowb

CD4 cell count (< 200 versus ≥ 200 cells/mm3)

4 (cohort studies)

Hazard ratio: 2.98 (95% CI, 2.23–4.0)

Moderatec

CD4 cell count (< 100 versus ≥ 100 cells/mm3)

2 (cross-sectional)

Odds ratio: 1.14 (95% CI, 0.52–2.47)

Lowd

  1. SD study design
  2. aDowngraded once to indirectness, the final sample of some of the included studies only represents the population of interest
  3. bImprecision and inconsistency were major concerns, imprecision due to a limited number of studies and wide confidence intervals, and there was a substantial heterogeneity statistical heterogeneity (heterogeneity: Tau2 = 0.25; chi2 = 6.25, df = 2(P = 0.03), I2 = 71%) and marked clinical heterogeneity
  4. cDowngraded once due to a risk of bias, bias to statistical analysis and reporting, and potential confounding factors
  5. dImprecision due to a limited number of participants and studies included. Inconsistency as there was a moderate statistical heterogeneity (heterogeneity: Tau2 = 0.18; chi2 = 1.95, df = 1 (P = 0.16); I2 = 49%)
  6. GRADE Working Group grades of evidence
  7. High certainty: We are very confident that the true effect lies close to that of the estimate of the effect
  8. Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
  9. Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect