Table 3.
Summary of findings and assessment of quality of evidence for outcomes
| Outcomes | No of Patients (Studies) | Quality Assessment | Summary of Findings | Quality of Evidence | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Study Limitation | Inconsistency | Indirectness | Imprecision | Publication Bias | Relative Effect (95% CI) | Anticipated Absolute Effects | ||||
| Usual Care | Integrated Care | |||||||||
| All-cause mortality | 4126 (11) | None | None | None | −1a | Undetected | 0.86 (0.68 to 1.08) | 9 per 100 | 7 less per 100 (6 less to 9 more) | ⊕⊕⊕○ Moderate |
| All-cause hospitalization | 568 (3) | −2b | −2c | None | −1a | Not estimable | 0.38 (0.15 to 0.95) | 35 per 100 | 13 less per 100 (5 less to 33 less) | ⊕○○○ Very low |
| Health-related quality of life | 2864 (4) | −1d | None | None | None | Not estimable | — | The mean health-related quality of life ranged from 0.67 to 89.4e | The SMD health-related quality of life in the intervention group was 0.02 higher (0.05 lower to 0.10 higher) | ⊕⊕⊕○ Moderate |
| eGFR, ml/min per 1.73 m2 | 523 (4) | −1d | −2c | None | −1a | Not estimable | — | The mean eGFR ranged from 15 to 49 | The mean eGFR in the intervention group was 1.51 higher (3.25 lower to 6.27 higher) | ⊕○○○ Very low |
| RRT | 403 (3) | −1d | −1f | None | −2g | Not estimable | 1.00 (0.65 to 1.55) | 14 per 100 | 14 per 100 (9 less to 21 more) | ⊕○○○ Very low |
| Controlled BP, <130/80 mm Hg | 1626 (4) | −1d | −1f | None | −1a | Not estimable | 1.20 (1.00 to 1.44) | 45 per 100 | 54 more per 100 (45 less to 65 more) | ⊕○○○ Very low |
95% CI, 95% confidence interval; ⊕, level of evidence; ○, no level of evidence; —, not applicable; SMD, standardized mean difference.
95% confidence interval includes possible benefits from both usual care and integrated care.
One of the studies had an unclear risk of bias on all of the quality domains (47).
Wide variance of point estimates across studies and significant heterogeneity between studies.
Most of the studies had an unclear risk of bias on allocation concealment and/or selective reporting, and high or unclear risk of bias for blinding of participants or outcome assessors.
Measured with different health-related quality-of-life scales (e.g., Health Utility Index 3, European Quality of Life-5 Dimensions, Kidney Disease Quality of Life Short Form, World Organization of National Colleges, Academies and Academic Association of General Practitioners, and Kidney Disease Quality of Life).
Wide variance of point estimates across studies or large heterogeneity between studies (I2>50%).
Adverse event in only small proportion of studies and 95% confidence interval includes possible benefits from both usual care and integrated care.