Table 3.
Quality of evidence in included reviews with GRADE.
| Outcome | Systematic review | N/n | Effect (95%) | GRADE | Quality of evidence | ||||
|---|---|---|---|---|---|---|---|---|---|
| Risk of bias | Inconsistency | Indirectness | Imprecision | Publication bias | |||||
| Mortality outcomes | |||||||||
| Mortality | Hong and Lee [16] | 8 (1518) | RR 0.85 [0.64, 1.13] | –2 | –1 | 0 | 0 | 0 | L |
| Sul et al. [18] | 7 (919) | RR 0.89 [0.60, 1.34] | –1 | –1 | 0 | 0 | 0 | L | |
| McLean et al. [23] | 3 (503) | RR 1.05 [0.63, 1.75] | –1 | 0 | 0 | –1 | 0 | L | |
|
| |||||||||
| Exacerbation outcomes | |||||||||
| Hospitalizations | Hong and Lee [16] | 14 (2007) | RR 0.88 [0.80, 0.97] | –1 | –1 | 0 | 0 | 0 | L |
| McCabe et al. [20] | 1 (239) | OR 1.60 [0.80, 3.20] | –1 | — | 0 | –1 | 0 | L | |
| McLean et al. [23] | 4 (604) | OR 0.46 [0.33, 0.65] | –1 | 0 | 0 | 0 | 0 | M | |
| Exacerbation rate | Sul et al. [18] | 6 (NR) | RR 0.67 [0.31, 1.42] | –1 | 0 | 0 | –1 | 0 | L |
| McCabe et al. [20] | 1 (239) | OR 1.40 [0.70, 2.80] | –1 | — | 0 | –1 | 0 | L | |
| Emergency room visits | Hong and Lee [16] | 11 (1282) | RR 0.63 [0.55, 0.72] | –1 | –1 | 0 | 0 | 0 | L |
| McLean et al. [23] | 3 (449) | OR 0.27 [0.11, 0.66] | –1 | 0 | 0 | –1 | 0 | L | |
|
| |||||||||
| Quality of life | |||||||||
| SGRQ total scores | Hong and Lee [16] | 4 (604) | MD –0.21 [–3.29, 2.86] | –1 | 0 | 0 | –1 | 0 | L |
| Sul et al. [18] | 9 (522) | MD 0.14 [–3.96, 4.23] | –1 | –1 | 0 | –1 | 0 | VL | |
| Deng et al. [19] | 6 (712) | SMD –0.36 [–0.51, 0.06] | –1 | –1 | 0 | 0 | 0 | L | |
| McCabe et al. [20] | 3 (472) | MD –0.22 [–0.40, –0.03] | –1 | –1 | 0 | 0 | 0 | L | |
| McLean et al. [23] | 2 (253) | MD –6.57 [–13.62, 0.48] | –1 | –1 | 0 | –1 | 0 | VL | |
|
| |||||||||
| Exercise capacity | |||||||||
| 6MWD | Deng et al. [19] | 7 (570) | SMD 0.30 [0.00, 0.60] | –1 | –1 | 0 | 0 | 0 | L |
| Lundell et al. [22] | 5 (NR) | MD –1.3 [–8.10, 5.50] | –1 | –1 | 0 | –1 | 0 | VL | |
NR: not reported; -2: very serious; -1: serious; 0: not serious; /: inapplicability; VL: very low; L: low; M: moderate.