Table 4.
Quality of evidence according to GRADE approach
| No. of studies | Certainty assessment |
Relative effect (95% confidence interval) | Certainty | |||||
|---|---|---|---|---|---|---|---|---|
| Study design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | |||
| pCR in patients with ER-low compared with ER-positive breast cancer (assessed with: odds ratio) | ||||||||
| 6 | Observational studies | Serious | Not serious | Not serious | Not serious | None | 3.25 (1.85-5.71) | ⊕⊕⊕◯ MODERATE |
| pCR in patients with ER-low compared with ER-negative breast cancer (assessed with: odds ratio) | ||||||||
| 7 | Observational studies | Serious | Serious | Not serious | Not serious | None | 1.37 (0.83-2.22) | ⊕⊕◯◯ LOW |
| Disease-free survival ER-low versus ER-positive (assessed with: hazard ratio) | ||||||||
| 7 | Observational studies | Serious | Not serious | Not serious | Not serious | None | 1.85 (1.35-2.54) | ⊕⊕⊕◯ MODERATE |
| Disease-free survival ER-low versus ER-negative (assessed with: hazard ratio) | ||||||||
| 5 | Observational studies | Serious | Serious | Not serious | Not serious | None | 1.09 (0.93-1.26) | ⊕⊕◯◯ LOW |
| Overall survival ER-low versus ER-positive (assessed with: hazard ratio) | ||||||||
| 6 | Observational studies | Serious | Not serious | Not serious | Not serious | None | 2.36 (1.35-3.86) | ⊕⊕⊕◯ MODERATE |
| Overall survival ER-low versus ER-negative (assessed with: hazard ratio) | ||||||||
| 5 | Observational studies | Serious | Serious | Not serious | Not serious | None | 1.16 (0.98-1.38) | ⊕⊕◯◯ LOW |
ER, estrogen receptor; GRADE, Grading of Recommendations Assessment, Development and Evaluation; pCR, pathologic complete response.