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Table 2 GRADE summary of findings

From: A systematic review and meta-analysis assessing antiretroviral therapy for treatment-experienced HIV adult patients using an optimized background therapy approach: is there evidence enough for a standardized third-line strategy?

New ARV + OBT compared to placebo or standard ARV + OBT for HIV-1-infected patients with resistance to 3 classes of ARV

Patient or population: patients with HIV-1 infected patients with resistance to 3 classes of ARV

Settings:

Intervention: new ARV + OBT

Comparison: placebo or standard ARV + OBT

Outcomes

Illustrative comparative risksa (95% CI)

Relative effect

(95% CI)

No. of Participants

(studies)

Quality of the evidence

(GRADE)

Assumed risk

Corresponding risk

 
 

Placebo or standard ARV + OBT

New ARV + OBT

   

proportion of patients achieving viral load < 50 copies/ml

Follow-up: mean 48 weeks

315 per 1000

465 per 1000 (438 to 493)

RR 1.478 (1.392 to 1.568)

7709 (18 studies)

 ⊕  ⊕  ⊕  ⊝ moderateb,c,d

CD4 cell count increase

Follow-up: mean 48 weeks

The mean cd4 cell count increase in the control groups was 57.21 mean change in CD4 count from baseline (cells/ul)

The mean cd4 cell count increase in the intervention groups was 40.22 higher (38.54 to 41.89 higher)

 

7689 (18 studies)

 ⊕  ⊝  ⊝  ⊝ very lowb,c,e

GRADE Working Group grades of evidence

High quality: Further research is very unlikely to change our confidence in the estimate of effect

Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate

Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate

Very low quality: We are very uncertain about the estimate

  1. CI confidence interval, RR risk ratio
  2. aThe basis for the assumed risk (e.g., the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI)
  3. bMost studies have more than one item with high risk of bias or uncertain risk of bias. Only 2 of 16 studies evaluated have low risk of bias in all 6 criteria
  4. cThe studies evaluated different ARV and the comparison group varied between studies. The OBT design does not allow direct assessment of treatment effectiveness at an individual level
  5. dMost studies present favorable results to experimental group
  6. eThe difference in CD4 increase between the experimental and control groups varied widely from study to study
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Systematic Reviews

ISSN: 2046-4053