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. 2021 Sep 19;59(1):1258–1273. doi: 10.1080/13880209.2021.1973038

Table 4.

GRADE evidence profile of clinical efficacy and safety.

Out comes (trials) Quality assessment
No of patients
Clinical efficacy and safety
Quality
Risk of bias Inconsistency Indirectness Imprecision Publication bias Aidi plus GBC GBC Relative ratio (95% CI) Absolute effects
ORR (50) Seriousa No serious No serious No serious None 1041/1894 (55.0%) 735/1848 (39.8%) 1.38 (1.29–1.48) 151 more per 1000 (from 115 more to 191 more) ⊕⊕⊕ moderate
DCR (49) Seriousa No serious No serious No serious None 1604/1876 (85.5%) 1355/1826 (74.2%) 1.15 (1.12–1.19) 111 more per 1000 (from 89 more to 141 more) ⊕⊕⊕ moderate
QOL (24) Seriousa No serious No serious No serious None 565/960 (58.9%) 311/909 (34.2%) 1.71 (1.54–1.89) 243 more per 1000 (from 185 more to 304 more) ⊕⊕⊕ moderate
Gastrointestinal toxicity (33) Seriousa No seriousb No serious No serious Nonec 458/1352 (33.9%) 703/1332 (52.8%) 0.64 (0.59–0.70) 190 fewer per 1000 (from 158 fewer to 216 fewer) ⊕⊕⊕ moderate
Thrombocytopenia (17) Seriousa No seriousb No serious No serious None 134/653 (20.5%) 198/647 (30.6%) 0.64 (0.54–0.77) 110 fewer per 1000 (from 70 fewer to 141 fewer) ⊕⊕⊕ moderate
Neutropenia (37) Seriousa No seriousb No serious No serious Nonec 457/1335 (34.2%) 702/1313 (53.5%) 0.63 (0.58–0.69) 198 fewer per 1000 (from 166 fewer to 225 fewer) ⊕⊕⊕ moderate
Liver injury (20) Seriousa No serious No serious No serious Nonec 123/869 (14.3%) 215/861 (25.0%) 0.57 (0.47–0.69) 107 fewer per 1000 (from 77 fewer to 132 fewer) ⊕⊕⊕ moderate
Renal injury (7) Seriousa No serious No serious Seriousd None 27/325 (8.3%) 56/117 (13.3%) 0.48 (0.31–0.74) 92 fewer per 1000 (from 46 fewer to 122 fewer) ⊕⊕ low
Anaemia (7) Seriousa No serious No serious Seriousd None 61/370 (16.5%) 105/369 (28.5%) 0.58 (0.44–0.76) 120 fewer per 1000 (from 68 fewer to 159 fewer) ⊕⊕ low

Note: Aidi: Aidi injection; GBC: gemcitabine-based chemotherapy; RR, relative ratio; CI: confidence interval; ORR: objective response rate; DCR: disease control rate; QOL: quality of life.

aMost domain trials mentioned applying a randomisation methodology, but few of included study specified the method and none of the trials specified the methods of allocation concealment and the blinding procedures. Therefore, evidence was rated down by only one level.

bConsiderable heterogeneity and the results had good robustness. Not rated down

cNot rated down. The ADRs were over-estimated.

dThe total sample size did not reach the optimal information size, and the sample size for each indicator was less than 300 cases, and the evidence was rated down by one level.