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Table 1 Summary of findings to evaluate the certainty of the evidence, using the GRADE methodology

From: Effects of dog-assisted therapy in adults with dementia: a systematic review and meta-analysis

Outcomes Anticipated absolute effects* (95% CI) Relative effect (95% CI) № of participants and studies (I: intervention, C: control) Certainty of the evidence (GRADE) Comments
Risk with Animal-assisted therapy
Activities of daily living SMD 0.16 SD more (0.80 lower to 1.12 more) I 31 C 30 (2 RCTs) VERY LOWa,b,c We are uncertain about the effect of DAT on activities of daily living.
Depression SMD 0.48 SD lower (1.93 lower to 0.98 higher) I 80 C 82 (4 RCTs) VERY LOWa,b,c,d We are uncertain about the effect of DAT on depression.
Agitation SMD 1.12 SD lower (2.67 lower to 0.43 higher) I 86 C 87 (3 RCTs) VERY LOWa,b,c We are uncertain about the effect of DAT on agitation.
Quality of life SMD 0.16 SD higher (0.41 lower to 0.73 higher) I 76 C 75 (3 RCTs) VERY LOWb,c,e We are uncertain about the effect of DAT on quality of life.
Cognitive impairment SMD 0.52 SD lower (1.33 lower to 0.30 higher)   I 12 C 12 (1 RCT) VERY LOWa,c We are uncertain about the effect of DAT on cognitive impairment.
Apathy SMD 2.10 SD higher (1.29 higher to 2.91 higher)   I 19 C 18 (1 RCT) VERY LOWa,c We are uncertain about the effect of DAT on apathy.
  1. Explanations
  2. a. Blinding of outcome assessment was not detailed in the publication.
  3. b. Point estimates vary widely, and confidence intervals do not overlap.
  4. c. Sample sizes were small (< 400).
  5. d. Risk of bias due to inadequate measurement of outcomes.
  6. e. RCTs were not blinded. Selective reporting possibly occurred in one of the included RCT