. 2023 Dec 20;110(4 Suppl):38–43. doi: 10.4269/ajtmh.22-0727

Table 2.

Grading of Recommendations Assessment Development and Evaluation summary of findings

Outcomes	Studies and Participants	Rate Ratio (95% CI)	Anticipated absolute effects^* (95% CI)		Certainty
Outcomes	Studies and Participants	Rate Ratio (95% CI)	Risk with no MRP	Risk with MRP	Certainty
Incidence < 1 month post-MRP	1 nonrandomized study (n = 813,232)	RR 0.07 (0.05–0.08)	36 per 1,000 person-years	3 per 1,000 (2–3)	Very low^†^‡^§^ǁ
Incidence 1–3 months post-MRP	2 nonrandomized studies (n = 873,232)	RR 0.08 (0.07–0.08)	111 per 1,000 person-years	9 per 1,000 (8–9)	Very low^†^§^ǁ ^¶
Incidence 4–12 months post-MRP	2 nonrandomized studies (n = 873,232)	RR 0.20 (0.18–0.22)	13 per 1,000 person-years	3 per 1,000 (2–3)	Very low^†^§^ǁ ^¶
Prevalence <1 month post-MRP	1 nonrandomized study (n = 9,353)	RR 0.12 (0.03–0.52)	0 per 1,000	0 per 1,000 (0–2)	Very low^†^§^ǁ ^¶
Prevalence 4–12 months post-MRP	1 nonrandomized study (n = 6,710)	RR 0.07 (0.01–0.57)	4 per 1,000	0 per 1,000 (0–2)	Very low^†^‡^§^ǁ
Adverse events	1 nonrandomized study (n = 333,946)	Not estimable	0 per 1,000	0 per 1,000 (0–0)	Very low^†^‡^#^**

MRP = mass relapse prevention; RR = rate ratio.

The risk in the intervention group (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).

^{^†}

Downgraded by 2 due to risk of bias. Many risk of bias domains judged as high risk or not enough information to determine. High risk of bias due to confounding in both studies included for this outcome.

^{^‡}

Not downgraded for inconsistency due to single study result.

^{^§}

Not downgraded for indirectness because evidence was judged to be sufficiently direct for the domains of population, intervention, comparison, direct comparison, and outcome.

^{^ǁ}

Not downgraded for imprecision because lower and upper confidence limits indicate the same direction of effect.

^{^¶}

Not downgraded for inconsistency. Both studies provided the same direction and a similar magnitude (qualitatively) of effect.

^{^#}

Downgraded by 2 due to indirectness. Side effects were not measured or reported in the control group, so evidence is only provided in the intervention population.

^**

Not downgraded for imprecision because this criterion is not applicable for this outcome (no effect measure presented).