Table A2:
GRADE Evidence Profile for Comparison of Team-Based Discussions and Usual Care or No Discussion
| Number of Studies (Design) | Risk of Bias | Inconsistency | Indirectness | Imprecision | Publication Bias | Upgrade Considerations | Quality |
|---|---|---|---|---|---|---|---|
| Patient's Quality of Life | |||||||
| 1 (RCT) | No serious limitations | No serious limitations | No serious limitations | Serious limitations (−1)a | Undetected | None | ⊕⊕⊕ Moderate |
| Patient's Satisfaction with End-of-Life Care | |||||||
| 1 (RCT) | No serious limitations | No serious limitations | No serious limitations | No serious limitations | Undetected | None | ⊕⊕⊕⊕ High |
| Completion of Advance Care Planning Documents and Processes | |||||||
| 1 (RCT) | No serious limitations | No serious limitations | No serious limitations | No serious limitations | Undetected | None | ⊕⊕⊕⊕ High |
| Receiving Hospital Care | |||||||
| 1 (observational) | No serious limitations | No serious limitations | No serious limitations | Serious limitations (−1)a | Undetected | All plausible confounding increases confidence in estimate (+1) | ⊕⊕ Low |
| Hospital Length of Stay | |||||||
| 2 (RCT) | Serious limitations (−1)b | Serious limitations (−1)c | No serious limitations | No serious limitations | Undetected | None | ⊕⊕ Low |
| Emergency Department Visits | |||||||
| 1 (observational) | No serious limitations | No serious limitations | No serious limitations | No serious limitations | Undetected | All plausible confounding increases confidence in estimate (+1) | ⊕⊕⊕ Moderate |
| Intensive Care Unit Length of Stay | |||||||
| 2 (RCT) | No serious limitations | No serious limitations | No serious limitations | No serious limitations | Undetected | None | ⊕⊕⊕⊕ High |
| Urgent Care Visits | |||||||
| 1 (observational) | No serious limitations | No serious limitations | No serious limitations | No serious limitations | Undetected | All plausible confounding increases confidence in estimate (+1) | ⊕⊕⊕ Moderate |
| Other Outpatient Visits | |||||||
| 1 (observational) | No serious limitations | No serious limitations | No serious limitations | Serious limitations (−1)a | Undetected | Large magnitude of effect (+1) All plausible confounding increases confidence in estimate (+1) | ⊕⊕⊕ Moderate |
Abbreviations: GRADE, Grading of Recommendations Assessment, Development, and Evaluation; RCT, randomized controlled trial.
a
Wide confidence intervals.
b
RCTs suffer limitations because of blinding and allocation concealment.
c
One study showed that the intervention had beneficial effects and the other showed no effect.