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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)