TABLE 4.
The summary findings by the grading recommendations assessment, development, and evaluation (GRADE) methods.
| Certainty assessment | Summary of findings | Comments | ||||||||
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| Participants (studies) follow-up | Risk of bias | Inconsistency | Indirectness | Imprecision | Publication bias | Overall certainty of evidence | Events | Anticipated absolute effects or relative effect (95% CI) | ||
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| Control | Experiment | |||||||||
| Total Effective Rate 444 (6 RCTs) | Seriousa | Not serious | Not serious | Not serious | None | ⊕⊕⊕○ Moderate | 132/222 (59.5%) | 182/222 (82.0%) | RR 1.38 (1.22–1.55) | Risk of bias (-1a) |
| LVEF 376 (5 RCTs) | Seriousa | Not serious | Not serious | Not serious | None | ⊕⊕⊕○ Moderate | 188 | 188 | SMD 0.79 higher (0.58–1.00) | Risk of bias (-1a) |
| LVDD 242 (3 RCTs) | Seriousa | Seriousb | Seriousc | Not serious | None | ⊕⊕○○ Low | 121 | 121 | MD 1.67 higher (0.25–3.09) | Risk of bias (-1a) Inconsistency (-1b) Indirectness (-1c) |
| IVRT 152 (2 RCTs) | Seriousa | Seriousb | Not serious | Not seriouse | Yesd | ⊕○○○ Very low | 76 | 76 | MD 6.7 lower (8.28 lower to 5.14 lower) | Risk of bias (-1a) Inconsistency (-1b) Imprecision (-1e) Publication bias (-1d) |
| Peak A 152 (2 RCTs) | Seriousa | Seriousb | Not serious | Not seriouse | Yesd | ⊕○○○ Very low | 76 | 76 | MD 4.4 lower (4.81 lower to 3.99 lower) | Risk of bias (-1a) Inconsistency (-1b) Imprecision (-1e) Publication bias (-1d) |
| SV 156 (2 RCTs) | Seriousa | Seriousb | Not serious | Not seriouse | Yesd | ⊕○○○ Very low | 78 | 78 | MD 7.99 higher (4.98 to 11.01) | Risk of bias (-1a) Inconsistency (-1b) Imprecision (-1e) Publication bias (-1d) |
| Adverse Events 388 (5 RCTs) | Seriousa | Not serious | Not serious | Not serious | None | ⊕⊕⊕○ Moderate | 19/194 (9.8%) | 23/194 (11.9%) | RR 1.16 (0.66 to 2.05) | Risk of bias (-1a) |
CI, confidence interval; MD, mean difference; RR, risk ratio; SMD, Standardized mean difference. (a.) There exists unclear risk of bias as showed in Table 2; (b.) The sample size was too small; c. The direction of the effect is different as 50 < I2 ≤ 75%; d. all plausible residual confounding would reduce the demonstrated effect; e. the number of studies is small. ⊕ The evidence’s confidence upgrade 1 level; ○ the evidence’s confidence downgrade 1 level.