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Table 3 Sensitivity analyses for associations of depression and all-cause mortality supported by highly suggestive (class II) evidence

From: The association of depression and all-cause and cause-specific mortality: an umbrella review of systematic reviews and meta-analyses

Subgroup Sample size MDD/Deaths k Largest study ES (95% CI)a Random effects summary ESb (95% CI) Random effects P valuec 95% prediction interval I2 (%) Excess significance Classification
O/Ed P value
All-cause in cancer
 Structured interview 145/462 5 2.85 (2.29–3.54) 1.56 (0.87–2.8) 0.133 0.28–8.56 71.9 1/1.02 0.979 Weak
 Adjusted estimates only 1066/2273 13 1.2 (0.9–1.4) 1.6 (1.35–1.9) < 10−6 1.02–2.51 42.3 8/5.16 0.097 Class III
 Adjusted at least for age and sex 691/1030 6 1.2 (0.9–1.4) 1.69 (1.23–2.31) 0.001 0.77–3.68 51.6 4/3.3 0.563 Class III
 Adjusted comorbidities 910/1951 9 1.2 (0.9–1.4) 1.52 (1.27–1.83) < 0.001 0.97–2.4 43.3 5/3.54 0.3 Class III
 Inpatients 764/618 10 1.66 (1.16–2.37) 1.7 (1.35–2.13) < 0.001 0.96–3 40.9 6/3.55 0.106 Weak
 Outpatients 453/1418 10 1.3 (0.98–1.73) 1.56 (1.11–2.17) 0.009 0.57–4.28 75.3 4/2.57 0.291 Class III
 Prospective studies 4034/4817 23 1.37 (1.26–1.5) 1.55 (1.32–1.81) < 10−6 0.86–2.78 69.6 11/6.21 0.023 Class II
 Follow-up ≤ 5 years 946/1580 15 1.2 (0.9–1.4) 1.8 (1.42–2.28) < 0.001 0.83–3.9 68.1 9/6.64 0.22 Class III
 Follow-up > 5 years 3088/3237 8 1.37 (1.26–1.5) 1.29 (1.14–1.47) < 0.001 1–1.68 22.5 2/1.52 0.658 Class III
All-cause in heart failure patientse
 Adjusted estimates only 3383/4275 21 1.33 (1.19–1.42) 1.46 (1.29–1.64) < 10−6 0.93–2.27 79.1 14/9.83 0.068 Class II
 Adjusted at least for age and sex 2526/2935 13 1.33 (1.19–1.42) 1.36 (1.22–1.52) < 10−6 0.99–1.86 54.3 9/5.39 0.042 Class II
 Adjusted for comorbidities 2395/3371 12 1.33 (1.19–1.42) 1.43 (1.26–1.62) < 10−6 1–2.04 60.5 8/6.58 0.41 Class II
 Inpatients 1245/1500 7 2.02 (1.48–2.76) 1.82 (1.28–2.6) < 0.001 0.64–5.19 77.7 4/5.12 0.339 Class III
 Outpatients 639/583 6 1.31 (1.07–1.6) 1.46 (1.08–1.96) 0.013 0.67–3.16 75.2 4/1.8 0.049 Weak
 Prospective studies 3418/4345 22 1.33 (1.19–1.42) 1.46 (1.3–1.65) < 10−6 0.94–2.28 78.4 14/10.02 0.088 Class II
 Follow-up ≤ 5 years 2417/2358 16 1.33 (1.19–1.42) 1.52 (1.3–1.77) < 10−6 0.93–2.47 80.0 10/6.55 0.079 Class II
 Follow-up > 5 years 1001/1987 6 1.31 (1.07–1.6) 1.4 (1.14–1.72) 0.001 0.76–2.57 72.5 4/3.41 0.627 Class III
All-cause in mixed samplee
 Structured interview 4746/29667 19 2.3 (2.1–2.5) 1.64 (1.3–2.08) < 0.001 0.62–4.38 88.7 11/13.06 0.277 Class III
 Adjusted estimates only 83,470/212385 81 1.77 (1.41–2.17) 1.42 (1.33–1.5) < 10−6 0.93–2.15 86.5 44/16.69 0 Class II
 Adjusted at least for age and sex 51,332/161660 42 1.1 (1.07–1.13) 1.34 (1.25–1.43) < 10−6 0.96–1.85 82.4 23/15.72 0.017 Class II
 Adjusted for comorbidities 34,122/41488 53 1.77 (1.41–2.17) 1.38 (1.29–1.47) < 10−6 0.97–1.96 71.6 31/3.66 0 Class II
 Community 32,269/69181 62 1.77 (1.41–2.17) 1.48 (1.36–1.61) < 10−6 0.83–2.63 88.2 31/8.76 0 Class II
 Inpatients 2209/2334 16 1.44 (1.1–1.88) 1.58 (1.33–1.87) < 10−6 0.93–2.68 56.0 10/5.69 0.019 Class II
 Outpatients 811/497 6 1.55 (1.06–2.26) 1.47 (1.13–1.91) 0.004 0.8–2.68 34.5 4/0.58 0 Weak
 Primary care 8730/4558 6 1.04 (0.93–1.15) 1.44 (1.11–1.86) 0.006 0.67–3.1 82.0 4/2.13 0.11 Class III
 Prospective studies 46,951/96860 95 1.77 (1.41–2.17) 1.51 (1.4–1.62) < 10−6 0.86–2.63 87.1 51/11.97 0 Class II
 Follow-up ≤ 5 years 24,944/26135 61 1.37 (1.19–1.48) 1.62 (1.48–1.77) < 10−6 0.96–2.71 75.7 34/17.79 0 Class II
 Follow-up > 5 years 62,689/216442 40 1.77 (1.41–2.17) 1.36 (1.24–1.48) < 10−6 0.81–2.26 93.8 21/8.41 0 Class II
All-cause in post-AMI
 Structured interview 1688/638 5 1.48 (1.12–1.96) 2.37 (1.36–4.14) 0.002 0.41–13.76 86.3 4/4.12 0.886 Weak
 Adjusted estimates only 2381/1771 9 1.48 (1.12–1.96) 2.2 (1.51–3.2) < 0.001 0.71–6.81 80.7 7/7.88 0.374 Class III
 Adjusted for comorbidities 1507/579 3 1.48 (1.12–1.96) 1.56 (1.18–2.06) 0.001 0.79–3.1 5.1 2/2.15 0.843 Weak
 Inpatients 3998/2196 17 1.48 (1.12–1.96) 2.09 (1.63–2.69) < 10−6 0.9–4.85 70.3 10/12.89 0.102 Class II
 Prospective studies 4183/2358 20 1.48 (1.12–1.96) 2.09 (1.66–2.63) < 10−6 0.95–4.62 66.6 12/14.72 0.168 Class II
 Follow-up ≤ 5 years 3602/1789 16 1.67 (1.31–2.12) 2.18 (1.66–2.86) < 10−6 0.89–5.32 69.4 9/12.4 0.042 Class II
 Follow-up > 5 years 533/560 3 1.48 (1.12–1.96) 1.57 (1.25–1.99) < 0.001 0.94–2.63 0.0 2/1.31 0.42 Weak
  1. AMI acute myocardial infarction, CI confidence interval, E expected, ES effect size, MDD major depressive disorder, NA not available, NE not evaluated, NS not significant, O observed
  2. aES and 95% confidence interval of largest study (smallest standard error) in each meta-analysis
  3. bRandom effects refer to summary effect size (95% CI) using the random effects model
  4. cP value of summary random effects estimate
  5. dExpected number of statistically significant studies using the point estimate of the largest study (smallest standard error) as the plausible effect size
  6. eInclude community samples, inpatients, outpatients and primary care