Table 5 Grading of recommendation, assessment, development, and evaluation (GRADE) instrument
From: Association of cerebral malaria and TNF-α levels: a systematic review
Certainty assessment | Impact | Certainty | Importance | ||||||
|---|---|---|---|---|---|---|---|---|---|
Number of studies | Study design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | |||
Levels of TNF-a in adult patients | |||||||||
3 | observational studies | not serious | not serious | not serious | not serious | none | In three studies, 80 patients with cerebral malaria and 40 patients with severe malaria were evaluated. The mean TNF alpha level was significantly higher in cerebral malaria than in severe malaria in all evaluated studies. The mean levels of TNF alpha level varied from 52.40 to 53.26 pg/ml in the cerebral malaria group. No information was reported among means of TNF alpha level in severe malaria group. | ⨁⨁◯◯ LOW | CRITICAL |
Levels of TNF-a in children patients | |||||||||
4 | observational studies | not serious | not serious | not serious | not serious | none | In four studies, 98 patients with cerebral malaria and 101 patients with severe malaria were evaluated. The mean of TNF alpha level, as well as the immunoexpression reported by one study, were significantly higher in cerebral malaria when compared to severe malaria in the evaluated studies. No information was reported among means of TNF alpha level in both groups. | ⨁⨁◯◯ LOW | CRITICAL |