Table A3:
GRADE Evidence Profile for Included Observational Studies on the Determinants of Nursing Home Versus Hospital Death
| Number of Studies | Risk of Bias | Inconsistency | Indirectness | Imprecision | Publication Bias | Upgrade Considerations | Quality |
|---|---|---|---|---|---|---|---|
| End-of-life care in the nursing home | |||||||
| 4 | No serious limitations | No serious limitations | No serious limitations | No serious limitations | Undetected | ⊕⊕ Low | |
| Preference for nursing home death | |||||||
| 2 | No serious limitations | No serious limitations | No serious limitations | No serious limitations | Undetected | ⊕⊕ Low | |
| Advance directives | |||||||
| 2 | No serious limitations | No serious limitations | No serious limitations | No serious limitations | Undetected | ⊕⊕ Low | |
| Cancer | |||||||
| 9 | No serious limitations | Serious limitationb | No serious limitations | No serious limitations | Undetected | ⊕ Very Low (inconsistency) | |
| Dementia | |||||||
| 3 | No serious limitations | Serious limitationb | No serious limitations | No serious limitations | Undetected | ⊕⊕ Low | |
| End-stage disease | |||||||
| 1 | No serious limitations | Serious limitationb | No serious limitations | No serious limitations | Undetected | ⊕⊕ Low | |
| Stroke | |||||||
| 2 | No serious limitations | Serious limitationb | No serious limitations | No serious limitations | Undetected | ⊕⊕ Low | |
| Functional status | |||||||
| 2 | No serious limitations | No serious limitations | No serious limitations | No serious limitations | Undetected | ⊕⊕ Low | |
| Family preference for home death | |||||||
| 1 | No serious limitations | N/A | No serious limitations | No serious limitations | Undetected | ⊕⊕ Low | |
| Full-time physician presence in the nursing home | |||||||
| 1 | No serious limitations | No serious limitations | No serious limitations | No serious limitations | Undetected | ⊕⊕ Low | |
| Hospital-based nursing home | |||||||
| 1 | No serious limitations | No serious limitations | No serious limitations | No serious limitations | Undetected | ⊕⊕ Low | |
| Nursing home bed availability | |||||||
| 3 | No serious limitations | No serious limitations | No serious limitations | No serious limitations | Undetected | ⊕⊕ Low | |
| Length of stay in nursing home | |||||||
| 2 | No serious limitations | No serious limitations | No serious limitations | No serious limitations | Undetected | ⊕⊕ Low | |
Abbreviations: GRADE, Grading of Recommendations Assessment, Development, and Evaluation; N/A, not applicable.
b
Substantial inconsistency across studies.