Table A16:
GRADE Evidence Profile for Comparison of GeneSight-Guided Treatment Selection With Treatment as Usual—Remission
| No. of Studies (Design) | Risk of Bias | Inconsistency | Indirectness | Imprecision | Publication Bias | Upgrade Considerations | Quality |
|---|---|---|---|---|---|---|---|
| Remission Based on HAM-D17 | |||||||
| 2 (RCT) | Very serious limitations (−;2)a | No serious limitations | No serious limitations | No serious limitations | Undetected | None | ⊕⊕ Low |
| 1 (observational) | Serious limitations (−;1)a | No serious limitations | No serious limitations | Serious limitations (−;1)b,c | Undetected | None | ⊕ Very Low |
| Remission Based on QIDS-C16 | |||||||
| 1 (RCT) | Very serious limitations (−;2)a | No serious limitations | No serious limitations | No serious limitations | Undetected | None | ⊕⊕ Low |
| 1 (observational) | Serious limitations (−;1)a | No serious limitations | No serious limitations | Serious limitations (−;1)b | Undetected | None | ⊕ Very Low |
| Remission Based on 9-Item Patient Health Questionnaire | |||||||
| 1 (RCT) | Very serious limitations (−;2)a | No serious limitations | No serious limitations | Serious limitations (−;1)c | Undetected | None | ⊕ Very Low |
| 1 (observational) | Serious limitations (−;1)a | No serious limitations | No serious limitations | Serious limitations (−;1)b,c | Undetected | None | ⊕ Very Low |
| Remission Based on HAM-D6 | |||||||
| 1 (RCT) | Very serious limitations (−;2)a | No serious limitations | No serious limitations | No serious limitations | Undetected | None | ⊕ Very Low |
Abbreviations: GRADE, Grading of Recommendations Assessment, Development, and Evaluation; HAM-D6, 6-item Hamilton Depression Rating Scale; HAM-D17, 17-item Hamilton Depression Rating Scale; QIDS-C16, 16-Item Quick Inventory of Depressive Symptomatology (clinician-rated); RCT, randomized controlled trial.
See Risk of Bias Table A5 and Table A6. Observational studies begin at low-quality GRADE and were not downgraded further owing to very serious risk of bias issues.
Study had small sample size, and number included at follow-up did not meet sample size calculation.
Effect estimate crosses null effect including both large benefit and no effect or harm.