Table 7.
Evidence profile of quality of life of institutionalized and non-institutionalized elderly for WHOQOL-BREF questionnaire
| Certainty assessment | Summary of findings | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| № of participants (studies) Follow-up |
Risk of bias | Inconsistency | Indirectness | Imprecision | Publication bias | Overall certainty of evidence | Study event rates (%) | Anticipated absolute effects | ||
| With NIE | With IE | Risk with NIE | Risk difference with IE |
|||||||
| WHOQOL-BREF – Overall | ||||||||||
| 5044 (5 observational studies) | not serious | serious a | not serious | not serious | all plausible residual confounding would suggest spurious effect, while no effect was observed | ⨁⨁◯◯LOW | 3157 | 1887 | – | SMD 0.69 lower(0.93 lower to 0.46 lower) |
| WHOQOL-BREF - General Health | ||||||||||
| 564 (3 observational studies) | very serious b | very serious a,c | not serious | serious d | strong associationall plausible residual confounding would suggest spurious effect, while no effect was observed | ⨁◯◯◯VERY LOW | 425 | 139 | – | SMD 0.24 lower(1.0 lower to 0.52 higher) |
| WHOQOL-BREF - Physical Health | ||||||||||
| 1120 (5 observational studies) | not serious | very serious a,c | not serious | not serious | all plausible residual confounding would suggest spurious effect, while no effect was observed | ⨁◯◯◯VERY LOW | 683 | 437 | – | SMD 0.69 lower(1.17 lower to 0.22 lower) |
| WHOQOL-BREF - Psychological Health | ||||||||||
| 1120 (5 observational studies) | not serious | very serious a,c | not serious | serious d | all plausible residual confounding would suggest spurious effect, while no effect was observed | ⨁◯◯◯VERY LOW | 683 | 437 | – | SMD 0.82 lower(1.4 lower to 0.24 lower) |
| WHOQOL-BREF - Social relationship | ||||||||||
| 1120 (5 observational studies) | serious e | serious a | not serious | serious d | all plausible residual confounding would suggest spurious effect, while no effect was observed | ⨁◯◯◯VERY LOW | 683 | 437 | – | SMD 0.88 lower(1.46 lower to 0.29 lower) |
| WHOQOL-BREF - Environmental area | ||||||||||
| 1120 (5 observational studies) | serious f | serious a | not serious | serious d | all plausible residual confounding would suggest spurious effect, while no effect was observed | ⨁◯◯◯VERY LOW | 683 | 437 | – | SMD 0.66 lower(1.26 lower to 0.07 lower) |
Notes: SMD Standard mean difference, a Considerable heterogeneity; b Only studies with some risk of bias were included in this analysis; c There is wide variation in the effect estimates across studies with little or no overlap of confidence intervals associated with the effect estimates; d Upper and lower confidence limit crosses the effect size were greater than 0.5; e Effect and significance (p value) change after exclusion of studies with risk of bias (SMD -0.16 [−0.35, 0.03] p = 0.09); f Effect and significance (p value) change after exclusion of studies with risk of bias (SMD -0.10 [− 0.29, 0.09] p = 0.3)