Table 3. The certainty of BLWT treatment effects for four behavioral symptoms.
| Outcomes | Initial certainty of evidence | Lower if | Higher if | Overall certainty of evidence | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Risk of bias | Inconsistency | Indirectness | Imprecision | Publication bias | Large effect | Dose response | All plausible residual confounding | |||
| Sleepiness | High (RCTs) | -1 (high risk in 3 of 6 trials) | - 2 (I2 = 88%) | 0 (all participants had a history of TBI) | -1 (p = 0.05) | -1 (asymmetry plot) | +1 (SMD = 0.92) | 0 (no evidence) | 0 (no evidence) | Very low |
| Sleep disturbance | -1 (high risk in 3 of 5 trials) | - 1 (I2 = 61%) | 0 (p = 0.03) | 0 (no asymmetry plot) | 0 (SMD = 0.63) | Low | ||||
| Depressive symptoms | -1 (high risk in 2 of 4 trials) | - 1 (I2 = 56%) | 0 (p < 0.01) | 0 (no asymmetry plot) | +1 (SMD = 1.00) | Moderate | ||||
| Fatigue | -1 (high risk in 2 of 4 trials) | - 2 (I2 = 91%) | -1 (p = 0.06) | -1 (asymmetry plot) | +1 (SMD = 1.44) | Very low | ||||
| Dropouts | -1 (high risk in 3 of 6 trials) | 0 (I2 = 0%) | -1 (p = 0.24) | 0 (no asymmetry plot) | 0 (RR = 0.66) | Low | ||||
BWLT: Blue-wavelength light therapy; RCT: randomized controlled trial; SMD = standardized mean differences; RR = risk ratio.