Table 10.
GRADE assessment – NO2 and ALRI mortality.
| Domain | Judgement | Down/Up Grade |
|---|---|---|
| Limitations in studies | 5 included studies. Risk of bias moderate for all studies, not all studies adjusted for all confounders. | No downgrading |
| Indirectness | All studies included the desired population, exposures and outcomes | No downgrading |
| Inconsistency | The 80% prediction interval included 1 but the PI was not > 2 × CI (Fig. 5). Substantial heterogeneity amongst small number of studies. | Downgrade one level |
| Imprecision | The number of person years in the included studies was greater than 940 000 | No downgrading |
| Publication Bias | No analysis of publication bias – too few studies | No downgrading |
| Large Effect Size | Summary RR = 1.02 Insufficient information on unmeasured potential confounders available | No upgrading |
| Plausible confounding towards null | Confounding direction unknown but precision may be affected | No upgrading |
| Dose-response relation | No information on shape. 95% CI for linear RR excluded 1. | Upgrade one level |
| GRADE conclusion | No downgrade and no upgrade | MODERATE CERTAINTY EVIDENCE MEAN RR UNADUSTED FOR CO-POLLUTANTS EQUALS 1.06 PER 10μ/m3 |