Summary of findings 2. Family therapy compared to psychological interventions for anorexia nervosa.

Family therapy compared to psychological interventions for anorexia nervosa
Participants: People of any age or gender with a primary clinical diagnosis of anorexia nervosa (AN) Intervention: Family therapy Comparator: Psychological interventions
Outcomes	№ of participants (studies) Follow up	Certainty of the evidence (GRADE)	Relative effect (95% CI)	Anticipated absolute effects* (95% CI)
				Risk with psychological interventions	Risk difference with Family therapy
Remission post‐intervention	252 (5 RCTs)	⊕⊝⊝⊝ VERY LOWa,b,c	RR 1.22 (0.89 to 1.67)	Study population
				488 per 1000	107 more per 1000 (54 fewer to 327 more)
Remission at long‐term follow‐up	200 (4 RCTs)	⊕⊝⊝⊝ VERY LOWa,d,e	RR 1.08 (0.91 to 1.28)	Study population
				703 per 1000	56 more per 1000 (63 fewer to 197 more)
All‐cause mortality ‐ long‐term outcome	0 ( studies)	‐	not pooled	Study population
				not pooled	not pooled
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio;
GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect

^aEvidence downgraded by one level due to high risk of selection bias in studies, arising from inadequate reporting of random sequence generation or allocation concealment. Evidence was also downgraded due to high risk of performance bias across all trials and often high risk of detection bias; there were several instances of reporting anomalies, some instances of missing data (at times high: up to 29.5% in one trial) not being adequately dealt with; and difficulties with outcomes being reported by subgroup or by total (in contrast to what was described in methods), or data from outcome measures not being reported at all.
 ^bEvidence downgraded by one level for inconsistency, as although heterogeneity was 37% and potentially not considered serious, the direction of effects variously favoured family therapy and psychological therapy.
 ^cEvidence downgraded by one level for imprecision, as the small effect observed was based on only five trials with 252 participants with wide confidence intervals that cross the line of no effect.
 ^dEvidence downgraded by one level for inconsistency, as although heterogeneity was 0%, the direction of effects variously favoured family therapy and psychological therapy.
 ^eEvidence downgraded by one level for imprecision, as the small effect observed was based on only four trials with 200 participants with wide confidence intervals that cross the line of no effect.