TABLE 2.
GRADE assessment tool: certainty in evidence for evaluated outcomes
| Outcome | Quality assessments | Effect | GRADE quality | ||||||
|---|---|---|---|---|---|---|---|---|---|
| Number of studies | Study design | Risk of bias | Imprecision | Inconsistency | Indirectness | Publication bias | RR (95% CI) | ||
| Risks of hand eczema with at least 8–10 times of daily handwashing | 29 | Observational studies | Not serious | Not serious | Serious a | Not serious | Not serious | 1.51 (1.35, 1.68) | ⊕⊕◯◯ Low |
| Risks of hand eczema with at least 15–20 times of daily handwashing | 20 | Observational studies | Not serious | Not serious | Not serious | Serious b | Not serious | 1.66 (1.51, 1.83) | ⊕⊕◯◯ Low |
| Risks of hand eczema with wet work | 7 | Observational studies | Not serious | Not serious | Not serious | Serious b | Not serious | 1.37 (1.24, 1.51) | ⊕⊕◯◯ Low |
| Risks of hand eczema with use of alcohol hand rub | 12 | Observational studies | Not serious | Not serious | Serious a | Not serious | Serious c | 1.20 (0.91, 1.58) | ⊕◯◯◯ Very low |
Note: Low quality: our confidence in the effect estimate is limited. The true effect may be markedly different from the estimate of the effect. Very low quality: we have very little confidence in the effect estimate. The true effect is likely to be markedly different from the estimate of effect.
Abbreviations: CI, confidence interval; RR, relative risk.
a
Heterogeneity statistic I 2 was greater than 70% and these outcomes were downgraded for inconsistency.
b
Downgraded for varied definitions of exposures in the studies.
c
Publication bias as demonstrated by asymmetrical funnel plot.