Table 3.
Summary of results and quality of evidence assessment using the GRADE approach.
| Outcome measure | Summary of findings | Quality of evidence assessment (GRADE) | ||||||
|---|---|---|---|---|---|---|---|---|
| No of patients (trials) | Effect size (95% CI) | Risk of bias a | Inconsistency b | Indirectness c | Imprecision d | Publication bias e | Quality of evidence f | |
| Lipid profile | ||||||||
| LDL-C (mg/dl) | 6,751 (51) | −4.81 (−6.04, −3.59) | Not Serious | Not Serious | Serious | Not Serious | Not Serious | Moderate |
| HDL-C (mg/dl) | 7,010 (54) | 0.66 (0.20, 1.12) | Not Serious | Not Serious | Serious | Serious | Serious | Very Low |
| TG (mg/dl) | 8,075 (59) | −2.51 (−3.62, −1.39) | Not Serious | Not Serious | Serious | Serious | Not Serious | Low |
| TC (mg/dl) | 8,006 (58) | −1.05 (−1.71, −0.39) | Not Serious | Not Serious | Serious | Serious | Not Serious | Low |
LDL, low-density lipoprotein; HDL, high-density lipoprotein; TG, triglyceride; TC, total cholesterol.
Risk of bias based on the AMSTAR2 results.
Downgraded if there was a substantial unexplained heterogeneity (I2 > 50%, P < 0.10) that was unexplained by meta-regression or subgroup analyses.
Downgraded if there were factors present relating to the participants, interventions, or outcomes that limited the generalizability of the results.
Downgraded if the 95% confidence interval (95% CI) crossed the minimally important difference (MID) for benefit or harm. MIDs used for each outcome were: 3.87 mg/dL for LDL, HDL, and TC, 8.86 mg/dL for TG.
Downgraded if there was an evidence of publication bias using funnel plot.
Since all included studies were meta-analyses of randomized control trials, the certainty of the evidence was graded as high for all outcomes by default and then downgraded based on prespecified criteria. Quality was graded as high, moderate, low, very low.