Table 4.
GRADE domains and overall certainty of evidence for the effects of exercise training on the outcomes
| Outcome | Certainty assessment | No of patients | Effect | Certainty | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| No of studies | Study design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | Exercise training | No training | Absolute (95% CI) |
|||
| Growth hormone | 4 | Randomized trials | Serious a,b,c | Not serious | Not serious | Serious d | None | 83 | 74 |
MD 0.48 ng/mL higher (− 0.02 lower to 0.99 higher) |
⨁⨁◯◯ LOW |
|
| IGF-I | 4 | Randomized trials | Serious a,b,c | Not serious | Not serious | Serious d | Publication bias strongly suspected e | 61 | 58 |
MD − 22.9 ng/mL lower (− 47.9 lower to 2.1 higher) |
⨁◯◯◯ VERY LOW |
|
| Testosterone | 7 | Randomized trials | Serious a,b,c | Serious f | Not serious | Serious d | None | 97 | 92 |
MD 0.84 nmol/L higher (− 0.2 lower to 1.9 higher) |
⨁◯◯◯ VERY LOW |
|
| SHBG | 3 | Randomized trials | Serious a,c | Serious f | Not serious | Serious d | Publication bias strongly suspected e | 31 | 28 |
MD − 5.5 nmol/L lower (− 19.4 lower to 8.2 higher) |
⨁◯◯◯ VERY LOW |
|
| Cortisol | 5 | Randomized trials | Serious a,c,g | Very serious h | Not serious | Serious d | None | 63 | 62 |
MD 17.4 nmol/L lower (− 88.5 lower to 53.7 higher) |
⨁◯◯◯ VERY LOW |
|
| IL-6 | 3 | Randomized trials | Serious a,c,i | Serious f | Not serious | Serious d | None | Statistical pooling was not possible for this variable |
⨁◯◯◯ VERY LOW |
|||
| TNF-α | 3 | Randomized trials | Serious a,c,i | Serious f | Not serious | Serious d | None | Statistical pooling was not possible for this variable |
⨁◯◯◯ VERY LOW |
|||
CI: Confidence interval; MD: Mean difference
a. Including at least one study with deviations from intended intervention
b. Including at least one study with unclear handling of missing data
c. Including at least one study with an unclear selection of the reported results
d. Small sample size
e. All studies from the same research group
f. Downgraded by 1 due to inconsistency in findings across studies
g. Including at least one study with some concerns with the randomization process
h. Downgraded by 2 due to inconsistency in findings across studies
i. Including at least one study with bias in the measurement of the outcome