Compound Danshen Dripping Pill for Treating Nonproliferative Diabetic Retinopathy: A Meta-Analysis of 13 Randomized Controlled Trials

Table 3

Result of GRADE.

Quality assessment							Summary of findings
Participants (studies) follow-up	Risk of bias	Inconsistency	Indirectness	Imprecision	Publication bias	Overall quality of evidence	Study event rates (%)		Relative effect (95% CI)	Anticipated absolute effects; Time frame is 2 months to 6 months
							With control group	With treatment group		Risk with control group	Risk difference with treatment group (95% CI)
Efficacy (critical outcome)
517; (7 studies); 2–6 months	Serious^1	No serious inconsistency	No serious indirectness	No serious imprecision	Reporting bias strongly suspected^2	⊕⊕⊝⊝; LOW^1,2 due to risk of bias, publication bias	115/252; (45.6%)	214/265; (80.8%)	RR 0.36 (0.28 to 0.46)	Study population
										456 per 1000	292 fewer per 1000; (from 246 fewer to 329 fewer)
										Moderate
										—
Microaneurysms (better indicated by lower values)
293; (5 studies); 2-3 months	Serious^1	No serious inconsistency	No serious indirectness	No serious imprecision	Reporting bias strongly   suspected^2	⊕⊕⊝⊝; LOW^1,2 due to risk of bias, publication bias	144	149	—		The mean microaneurysms in the intervention groups were; 4.32 lower; (5.41 to 3.23 lower)
Hemorrhage (better indicated by lower values)
405; (6 studies); 2–6 months	Serious^1	Serious^3	No serious indirectness	No serious imprecision	Reporting bias strongly suspected^2	⊕⊕⊝⊝; LOW^1,2,3 due to risk of bias, inconsistency, publication bias	200	205	—		The mean hemorrhage in the intervention groups was; 0.40 lower; (0.76 to 0.03 lower)
Exudates (better indicated by lower values)
196; (2 studies); 2–6 months	Serious^1	Serious^3	No serious indirectness	No serious imprecision	Reporting bias strongly suspected^2	⊕⊕⊝⊝; LOW^1,2,3 due to risk of bias, inconsistency, publication bias	98	98	—		The mean exudates in the intervention groups were; 0.09 lower; (0.71 lower to 0.54 higher)
Vision (better indicated by lower values)
272; (5 studies); 3 months	Serious^1	No serious inconsistency	No serious indirectness	No serious imprecision	Reporting bias strongly suspected^2	⊕⊕⊝⊝; LOW^1,2 due to risk of bias, publication bias	134	138	—		The mean vision in the intervention groups was; 0.12 lower; (0.21 to 0.04 lower)
FFA
266; (3 studies); 2–6 months	Serious^1	No serious inconsistency	No serious indirectness	No serious imprecision	Reporting bias strongly suspected^2	⊕⊕⊝⊝; LOW^1,2 due to risk of bias, publication bias	78/131; (59.5%)	33/135; (24.4%)	RR 0.4 (0.22 to 0.73)	Study population
										595 per 1000	357 fewer per 1000; (from 161 fewer to 464 fewer)
										Moderate
										—

risk of bias according to six items:adequate sequence generation, allocation concealment, blinding of participants and personnel, blinding of outcome assessment, incomplete outcome data addressed, and being free of selective reporting; we assessed high risk according to quality assessment criteria; ²check the publication bias of the systematic review that used the method of “inverted funnel” pattern analysis; the figure was asymmetrical, which showed that potential publication bias might influence the results of this paper; ³95% confidence intervals of 14 studies overlap are poor.