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Table 2 The results of the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) assessment of the evidence certainty on the association between the extravascular lung water and mortality

From: Extravascular lung water levels are associated with mortality: a systematic review and meta-analysis

Outcome Relative effect
(95% CI)
No. of patients No. of participants (studies) Downgrade factors Certainty of the evidence (GRADE) 18
Survivors Non-survivors Risk of bias Inconsistency Imprecision Indirectness Publication bias
Mortality OR 1.69
(1.22–2.34)
464/905
(51.3%)
441/905
(48.7%)
905 Adult patients
(11 studies)
Seriousa Seriousb Not serious Seriousc Not serious
VERY LOW
WMD − 4.97 mL/kg
(− 6.54; − 3.41)
680/1246
(54.6%)
566/1246
(45.4%)
1246 Adult patients
(17 studies)
Seriousa Seriousb Not serious Seriousc Not serious
VERY LOW
  1. CI confidence interval, OR odds ratio, WMD weighted mean difference
  2. aDowngraded by one level for the risk of bias because ten of 18 studies were evaluated as high risk of bias according to the QUIPS tool and four of 11 studies did not report adjusted OR. Nevertheless, no differences regarding the relative effects were observed between high and moderate and low risk of bias in subgroup analysis
  3. bDowngraded by one level for inconsistency: substantial heterogeneity is seen between studies (I2 > 75%)
  4. cDowngraded by one level for indirectness because different cut-off values for elevated EVLW definition (> 7 mL/kg/m2 in two studies, > 10 mL/kg/m2 in eight studies, not available in eight studies)