Table 9 |
|||||||||
|
Example of a modified GRADE evidence profile quality assessment. Table 9 and 10 is what Table 1 and 2 became when including the improvements made based on the pilot study experience. Question: Should depressed patients be treated with SSRIs rather than tricyclics? Setting: Primary care Patients: Moderately depressed adult patients Reference: North of England Evidence Based Guideline Development Project. Evidence based clinical practice guideline: the choice of antidepressants for depression in primary care. Newcastle upon Tyne: Centre for Health Services Research, 1997. |
|||||||||
|
Outcome: Depression severity (measured with Hamilton Depression Rating Scale after 4 to 12 weeks) |
|||||||||
|
|
|||||||||
|
Studies |
Design |
Quality |
Consistency |
Directness |
SD |
SA |
RB |
DR |
PC |
|
|
|||||||||
|
8 trials Citalopram 38 trials Fluoxetine 25 trials Fluvoxamine 2 trials Nefazodone 18 trials Paroxetine 4 trials Sertaline 4 trials Velafaxine |
RCTs |
No serious limitations |
No important inconsistency |
Some uncertainty about directness (outcome measure)* |
No |
No |
No |
No |
No |
|
|
|||||||||
|
Outcome: Transient side effects resulting in discontinuation of treatment |
|||||||||
|
|
|||||||||
|
8 trials Citalopram 50 trials Fluoxetine 27 trials Fluvoxamine 4 trials Nefazodone 23 trials Paroxetine 6 trials Sertaline 5 trials Velafaxine |
RCTs |
No serious limitations |
No important inconsistency |
Direct |
No |
No |
No |
No |
No |
|
|
|||||||||
|
Outcome: Poisoning fatalities |
|||||||||
|
|
|||||||||
|
Office for National Statistics (British) |
Observational data |
Serious limitation** |
Only one study |
Direct |
No |
++ |
No |
No |
No |
|
|
|||||||||
|
*There was uncertainty about the directness of the outcome measure because of the short duration of the trials. **It is possible that people at lower risk were more likely to have been given SSRI's and it is uncertain if changing antidepressant would have deterred suicide attempts. SD = Sparse data (Yes or No) SA = Strong association (No, + = strong, ++ = very strong) RB = Reporting bias (Yes or No) DR = Dose response (Yes or No) PC = All plausible confounders would have reduced the effect (Yes or No) CI = confidence interval WMD = weighted mean difference RRR = relative risk reduction |
|||||||||
|
Atkins et al. BMC Health Services Research 2005 5:25 doi:10.1186/1472-6963-5-25 |
|||||||||
