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Table 3 GRADE assessment of evidence quality

From: Systematic review and meta-analysis of the relationship between sleep disorders and suicidal behaviour in patients with depression

Quality assessment Effect Overall quality of evidence
No of studies Study design Risk of bias Inconsistency Indirectness Imprecision Publication bias Other considerations No of subjects Relative (95% CI)
Overall
 18 observational studies not serious Serious a not serious not serious detected Very strong association b 198,893 OR 2.45 (1.33 4.52) VERY LOW
Major depression
 12 observational studies not serious Serious a not serious not serious detected Very strong association b 5336 OR 2.92 (1.42 5.98) VERY LOW
Depression
 6 observational studies not serious not serious not serious not serious not detected none 193,557 OR 1.41 (1.14 1.73) LOW
  1. OR Odds ratio, CI Confidence interval
  2. a The score was downgraded because substantial heterogeneity between studies was detected and could not be fully explained
  3. b The score was upgraded because the magnitude of the effect was large (OR > 2 based on consistent evidence from at least two studies, with no plausible confounders)