Table 4 GRADE evidence profile for effectiveness of influenza vaccination in patients with end-stage renal disease
Quality assessment | No of patients | Effect | Quality | Importance | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
No of studies | Design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | Vaccination against influenza | Control | Relative (95% CI) | Absolute | ||
All-cause mortality | ||||||||||||
4 | Observational studies | Serious1 | No serious inconsistency | No serious indirectness | No serious imprecision | None | – | 1,798/8,759 (20.5%)2 | RR 0.68 (0.61–0.76)3 | 66 fewer per 1,000 (from 49 fewer to 80 fewer) | ⊕ΟΟΟ VERY LOW | CRITICAL |
10% | 32 fewer per 1,000 (from 24 fewer to 39 fewer) | |||||||||||
40% | 128 fewer per 1,000 (from 96 fewer to 156 fewer) | |||||||||||
Cardiac death | ||||||||||||
1 | Observational studies | Serious4 | No serious inconsistency | No serious indirectness | No serious imprecision | None | – | 5% | RR 0.84 (0.71–0.98)5 | 8 fewer per 1,000 (from 1 fewer to 15 fewer) | ⊕ΟΟΟ VERY LOW | CRITICAL |
10% | 16 fewer per 1,000 (from 2 fewer to 29 fewer) | |||||||||||
20% | 32 fewer per 1,000 (from 4 fewer to 58 fewer) | |||||||||||
Infectious death | ||||||||||||
1 | Observational studies | Serious4 | No serious inconsistency | No serious indirectness | No serious imprecision | None | – | 5% | RR 0.83 (0.65–1.05)5 | 9 fewer per 1,000 (from 18 fewer to 2 more) | ⊕ΟΟΟ VERY LOW | CRITICAL |
10% | 17 fewer per 1,000 (from 35 fewer to 5 more) | |||||||||||
20% | 34 fewer per 1,000 (from 70 fewer to 10 more) | |||||||||||
All-cause hospitalization | ||||||||||||
2 | Observational studies | Serious1 | No serious inconsistency | No serious indirectness | No serious imprecision | None | – | 1,688/1,888 (89.4%)6 | RR 0.88 (0.74–1.04)7 | 107 fewer per 1,000 (from 232 fewer to 36 more) | ⊕ΟΟΟ VERY LOW | CRITICAL |
20% | 24 fewer per 1,000 (from 52 fewer to 8 more) | |||||||||||
40% | 48 fewer per 1,000 (from 104 fewer to 16 more) | |||||||||||
Influenza/pneumonia hospitalization | ||||||||||||
4 | Observational studies | Serious8 | No serious inconsistency | No serious indirectness | No serious imprecision | None | – | 445/2,584 (17.2%) | RR 0.86 (0.8–0.93)3 | 24 fewer per 1,000 (from 12 fewer to 34 fewer) | ⊕ΟΟΟ VERY LOW | CRITICAL |
5% | 7 fewer per 1,000 (from 3 fewer to 10 fewer) | |||||||||||
30% | 42 fewer per 1,000 (from 21 fewer to 60 fewer) | |||||||||||
Hospitalization due to bacteremia, viremia or septicemia | ||||||||||||
1 | Observational studies | Serious4 | No serious inconsistency | No serious indirectness | No serious imprecision | None | – | 5% | RR 0.73 (0.32–1.68)5 | 13 fewer per 1,000 (from 34 fewer to 34 more) | ⊕ΟΟΟ VERY LOW | CRITICAL |
10% | 27 fewer per 1,000 (from 68 fewer to 68 more) | |||||||||||
20% | 54 fewer per 1,000 (from 136 fewer to 136 more) | |||||||||||
Hospitalization due to respiratory infection | ||||||||||||
1 | Observational studies | Serious4 | No serious inconsistency | No serious indirectness | No serious imprecision | None | – | 5% | RR 0.87 (0.69–1.09)5 | 6 fewer per 1,000 (from 16 fewer to 5 more) | ⊕ΟΟΟ VERY LOW | CRITICAL |
10% | 13 fewer per 1,000 (from 31 fewer to 9 more) | |||||||||||
20% | 26 fewer per 1,000 (from 62 fewer to 18 more) | |||||||||||
ICU admission | ||||||||||||
1 | Observational studies | Serious9 | No serious inconsistency | No serious indirectness | No serious imprecision | None | – | 184/2,696 (6.8%) | RR 0.19 (0.14–0.27) | 55 fewer per 1,000 (from 50 fewer to 59 fewer) | ⊕ΟΟΟ VERY LOW | CRITICAL |
12% | 97 fewer per 1,000 (from 88 fewer to 103 fewer) | |||||||||||
25% | 203 fewer per 1,000 (from 183 fewer to 215 fewer) | |||||||||||
Influenza-like illness | ||||||||||||
1 | Observational studies | Serious10 | No serious inconsistency | No serious indirectness | No serious imprecision | None | – | 5% | RR 0.88 (0.86–0.9)11 | 6 fewer per 1,000 (from 5 fewer to 7 fewer) | ⊕ΟΟΟ VERY LOW | CRITICAL |
10% | 12 fewer per 1,000 (from 10 fewer to 14 fewer) | |||||||||||
20% | 24 fewer per 1,000 (from 20 fewer to 28 fewer) | |||||||||||