Table 7: Overall GRADE and Strength of Recommendation (Including Uncertainty).

	Quality	Estimated Prevalence in Ontario	Cost-Effectiveness	Cost in Ontario	Risks/Burden	Benefits	Overall Grade & Strength of Recommendation
Severe, chronic refractory GP	Low	Incidence ~ 20 to 150	?	Cdn $107,000 to $1.6M	Removal rate ~ 5-10% of cases due to infection, stomach perforation, device migration/erosion. Cost effectiveness unknown. Ongoing/lifetime monitoring of patient. Battery change ~ 5 years. Post hoc change in end point analysis. Another RCT is underway.	Uncertain short/long- term benefits (reduced frequency of vomiting/nausea; improved gastric emptying; quality of life).	Weak
Morbid obesity	Very Low	~ 160,000 to 180,000	?	Uptake not determined in relation to other types of bariatric surgery (which are more effective).	Adverse effects – stomach perforation and lead dislodgment – difficult to determine rate given mid-study changes in surgical technique. Cost effectiveness and uptake unknown. Ongoing/lifetime monitoring of patient. Battery change ~ < 5 years?	Uncertain short/long-term benefits (EWL and improvement / resolution of comorbidities).	Weak