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Table 4 Evaluation of the quality of evidence according to GRADE system

From: Hypertension as a prognostic factor in metastatic renal cell carcinoma treated with tyrosine kinase inhibitors: a systematic review and meta-analysis

Quality assessment No. of patients Hazard Ratios (95% CI) Quality Importance
No of studies Design Risk of bias Inconsistency Indirectness Imprecision Other considerations TKI-induced hypertension Control
Progression-free survival (follow-up median 5.6–43.2 years; measured with: follow-up)
 20 observational studies no serious risk of bias serious1 no serious indirectness no serious imprecision reporting bias2 3021 1327 0.59 (0.48–0.71) Very low Critical
Overall survival (follow-up median 5.2–61.8 months; measured with: follow-up)
 17 observational studies no serious risk of bias serious1 no serious indirectness no serious imprecision reporting bias3 2313 1804 0.57 (0.45–0.70) Very low Critical
  1. 1The heterogeneity of this outcome was obvious between studies
  2. 2The shape of funnel plots was not symmetric. The Egger’s and Begg’s tests were further performed. The results indicated significant publication bias for studies, with merged PFS (Begg’s test, P = 0.015; Egger’s test, P = 0.028).
  3. 3The shape of funnel plots was not symmetric. The Egger’s and Begg’s tests were further performed. The results indicated significant publication bias for studies, with merged OS (Begg’s test, P = 0.026; Egger’s test, P = 0.085)