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Table 9 GRADE summary of findings table for preschool-age children (PSAC) [79]

From: Systematic review to evaluate a potential association between helminth infection and physical stunting in children

Certainty assessment No. of patients Effect Certainty Importance
No. of studies Study design Risk of bias Inconsistency Indirectness Imprecision Other considerations Anthelmintic Placebo Relative
(95% CI)
Absolute
(95% CI)
Height (cm)
5 Randomised trials Serious a Not serious Not serious Not serious All plausible residual confounding would suggest spurious effect, while no effect was observed 1240 1068 - MD 0.18 cm fewer
(0.6 fewer to 0.24 more)

High
CRITICAL
Height-for-age (HAZ) or length-for-age (LAZ)
2 Randomised trials Serious b Not serious Not serious Not serious None 477 468 - MD 0.02 more
(0.06 fewer to 0.1 more)

Moderate
CRITICAL
  1. Question: Anthelmintic compared to placebo in preschool-age children (PSAC) with helminthiasis to reduce stunting
  2. CI: confidence interval; MD: mean difference
  3. aRisk of bias upgraded by one level for height due to insensitive diagnostic test and short follow-up (Dossa et al., 2001), possible confounding due to Giardia (Gupta et al., 1982), insensitive diagnostic test and calcium placebo (Awasthi et al., 2000), malnourished children at baseline (Donnen et al., 1998), difference in sensitivity of diagnostic tests used for control and treatment groups and about 25% of participants received treatment from outside of the trial during the trial period (Joseph et al., 2015)
  4. bRisk of bias upgraded by one level for HAZ/LAZ due to insensitive diagnostic test and short follow-up (Dossa et al., 2001) and different sensitivity diagnostic tests used for control and treatment groups and about 25% of participants received treatment from outside of the trial during the trial period (Joseph et al., 2015)
  5. GRADE Working Group grades of evidence
  6. High certainty: we are very confident that the true effect lies close to that of the estimate of the effect
  7. Moderate certainty: we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
  8. Low certainty: our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect
  9. Very low certainty: we have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect