Table 3.
GRADE assessment of the quality of evidence in included trials.
| Question: PA compared to medical therapy/usual care for IBD | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Certainty assessment | No. of patients | Effect | Certainty | Importance | ||||||||
| No. of studies | Study design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | PA | Medical therapy/usual care | Relative (95% CI) |
Absolute (95% CI) |
||
| Health related quality of life (assessed with: SIBDQ, SF-36) | ||||||||||||
| 6 | Randomised trials | Very seriousa | Not serious | Not serious | Seriousb | None | 130 | 105 | — | SMD 0.34 SD higher (0.08 lower to 0.77 higher) |
⨁◯◯◯ Very low |
CRITICAL |
| Certainty of evidence was graded down due to imprecision (small sample sizes) and methodological limitations (lack of blinding of outcome assessors in most studies and possible attrition bias in one of the studies). Anxiety (assessed with: HADS) | ||||||||||||
| 4 | Randomised trials | Seriousc | Not serious | Not serious | Seriousd | None | 96 | 82 | — | SMD 0.35 SD lower (0.65 lower to 0.05 lower) |
⨁⨁◯◯ Low |
|
| Certainty of evidence was graded down by two levels due to study limitations (two of the studies had an overall unclear risk of bias and one had an overall high risk of bias) and imprecision (two of the studies had small sample sizes) HQoL-sensitivity analysis (assessed with: SIBDQ, SF-36) | ||||||||||||
| 5 | Randomised trials | Serious | Not serious | Not serious | Not serious | None | 108 | 92 | — | SMD 0.51 SD higher (0.22 higher to 0.79 higher) |
⨁⨁⨁◯ Moderate |
|
Setting: Clinical setting.
Note: CI, confidence interval; MD, mean difference; SMD, standardized mean difference.
a50% of the studies are judged to be of high risk of bias.
bThe lower boundary of the CI is negative and crosses the line of no effect.
cTwo of the studies are unclear and one high risk of bias.
dSmall sample size.
eSome level of heterogeneity.
fSmall sample size from the studies.