Table 1.
Short version of GRADE Summary of Findings
| Interventions | Outcomes | Impact | Certainty of the evidence (GRADE) |
| Cognitive–behavioral therapy | Functional disability | Effective | ⨁⨁◯◯ LOW |
| Disease activity | Effective | ⨁⨁◯◯ LOW | |
| Impairment/disability | Effective | ⨁⨁⨁◯ MODERATE | |
| Anxiety/depression | Effective | ⨁⨁◯◯ LOW | |
| Psychophysiological complains | Effective | ⨁⨁◯◯ LOW | |
| Sleep problems | Effective | ⨁⨁◯◯ LOW | |
| Pain | Effective | ⨁⨁◯◯ LOW | |
| Self-efficacy/self-helplessness | Effective | ⨁⨁⨁◯ MODERATE | |
| Quality of life/health status/social support | Effective | ⨁⨁◯◯ LOW | |
| Healthcare use | No effect | ⨁⨁◯◯ LOW | |
| Fatigue | Effective | ⨁⨁⨁◯ MODERATE | |
| Response training | Functional disability | Effective | ⨁⨁⨁◯ MODERATE |
| Disease activity | Effective | ⨁⨁⨁◯ MODERATE | |
| Impairment/disability | Effective | ⨁⨁⨁◯ MODERATE | |
| Psychophysiological complains | No effect | ⨁⨁◯◯ LOW | |
| Pain | Effective | ⨁⨁⨁◯ MODERATE | |
| Self-Efficacy/self-helplessness | Effective | ⨁⨁⨁◯ MODERATE | |
| Quality of life/Health status/Social support | Effective | ⨁⨁⨁◯ MODERATE | |
| Fatigue | Effective | ⨁⨁⨁◯ MODERATE | |
| Specific interactive disease education | Knowledge | Effective | ⨁⨁⨁◯ MODERATE |
| Functional disability | Effective | ⨁⨁◯◯ LOW | |
| Disease activity | Effective | ⨁⨁◯◯ LOW | |
| Impairment/disability | Effective | ⨁⨁◯◯ LOW | |
| Anxiety/depression | No effect | ⨁⨁⨁◯ MODERATE | |
| Psychophysiological complains | No effect | ⨁⨁⨁◯ MODERATE | |
| Pain | Effective | ⨁⨁◯◯ LOW | |
| Self-efficacy/self-helplessness | Effective | ⨁⨁◯◯ LOW | |
| Quality of life/health status/social support | Effective | ⨁⨁◯◯ LOW | |
| Fatigue | Effective | ⨁⨁◯◯ LOW | |
| Goal setting | Functional disability | Effective | ⨁⨁◯◯ LOW |
| Disease activity | Effective | ⨁⨁◯◯ LOW | |
| Impairment/disability | Effective | ⨁⨁⨁◯ MODERATE | |
| Anxiety/depression | Effective | ⨁⨁◯◯ LOW | |
| Psychophysiological complains | Effective | ⨁⨁◯◯ LOW | |
| Sleep problems | Effective | ⨁⨁⨁◯ MODERATE | |
| Pain | Effective | ⨁⨁◯◯ LOW | |
| Self-efficacy/self-helplessness | Effective | ⨁⨁◯◯ LOW | |
| Quality of life/health status/social support | Effective | ⨁⨁◯◯ LOW | |
| Fatigue | Effective | ⨁⨁◯◯ LOW | |
| Problem solving | Functional disability | Effective | ⨁⨁◯◯ LOW |
| Disease activity | Effective | ⨁⨁◯◯ LOW | |
| Impairment/disability | Effective | ⨁⨁◯◯ LOW | |
| Anxiety/depression | Effective | ⨁⨁◯◯ LOW | |
| Psychophysiological complains | Effective | ⨁⨁◯◯ LOW | |
| Sleep problems | Effective | ⨁⨁⨁◯ MODERATE | |
| Pain | Effective | ⨁⨁◯◯ LOW | |
| Self-efficacy/self-helplessness | Effective | ⨁⨁◯◯ LOW | |
| Quality of life/health status/social support | Effective | ⨁⨁◯◯ LOW | |
| Healthcare use | No effect | ⨁⨁⨁◯ MODERATE | |
| Fatigue | Effective | ⨁⨁◯◯ LOW | |
| Multicomponent or single exercise/physical activity interventions | Pain | Effective | ⨁⨁⨁◯ MODERATE |
| Functional disability | Effective | ⨁⨁◯◯ LOW | |
| Fatigue | Effective | ⨁⨁⨁⨁ HIGH | |
| Patient Global Assessment | Effective | ⨁⨁⨁◯ MODERATE | |
| BASDAI | Effective | ⨁⨁◯◯ LOW | |
| BASFI | Effective | ⨁⨁◯◯ LOW | |
| DAS-28 | No effect | ⨁◯◯◯ VERY LOW | |
| Psychosocial interventions | Pain | Effective | ⨁⨁⨁◯ MODERATE |
| Functional disability | Effective | ⨁⨁⨁◯ MODERATE | |
| Fatigue | Effective | ⨁⨁⨁◯ MODERATE | |
| Psychological status | Effective | ⨁⨁⨁◯ MODERATE | |
| Physical activity | Effective | ⨁⨁⨁◯ MODERATE | |
| Depression | Effective | ⨁⨁⨁◯ MODERATE | |
| Anxiety | Effective | ⨁⨁⨁◯ MODERATE | |
| Tender joints | Effective | ⨁⨁⨁◯ MODERATE | |
| Coping | Effective | ⨁⨁⨁◯ MODERATE | |
| Self-efficacy | Effective | ⨁⨁⨁◯ MODERATE | |
| DAS-28 | No effect | ⨁◯◯◯ VERY LOW | |
| Self-management interventions | Pain | Effective | ⨁⨁◯◯ LOW |
| Functional disability | No effect | ⨁◯◯◯ VERY LOW | |
| Educational interventions | Pain | Effective | ⨁⨁⨁◯ MODERATE |
| Fatigue | Effective | ⨁◯◯◯ VERY LOW | |
| Functional disability | Effective | ⨁⨁⨁◯ MODERATE | |
| Joint counts | Effective | ⨁⨁⨁◯ MODERATE | |
| Patient Global Assessment | Effective | ⨁⨁⨁◯ MODERATE | |
| Psychological status | Effective | ⨁⨁⨁◯ MODERATE | |
| Depression | Effective | ⨁⨁⨁◯ MODERATE | |
| Adherence | Effective | ⨁⨁⨁◯ MODERATE | |
| Self-efficacy | Effective | ⨁⨁⨁◯ MODERATE |
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.
BASDAI, Bath Ankylosing Spondylitis Disease Activity Index; BASFI, Bath Ankylosing Spondylitis Functional Index; DAS-28, Disease Activity Score-28; GRADE, Grading of Recommendations, Assessment, Development and Evaluation.