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Table 3 GRADE evaluation: quality of evidence and strength of recommendations

From: Vertical traction for lumbar radiculopathy: a systematic review

Quality

Summary of findings

Outcome

(No. of studies)

RoBa

Inconsistency

Indirectness

Imprecisionb

Publication biasc

No. of participants

Effect size

(SMD) with CId

GRADE

Vertical Traction + Physical Therapy VS Physical Therapy

Pain ST (1) (Prasad 2012 [35])

Not Serious

Not Serious

Not Serious

Serious

Likely

19e

−0.14 (−1.03 to 0.76)

LOW

Activity limitation ST (1)

(Prasad 2012 [35])

Not Serious

Not Serious

Not Serious

Serious

Likely

19e

−0.31 (−1.21 to 0.58)

LOW

Vertical Traction + Bed Rest VS Bed Rest

Pain ST (1)

(Moret 1998 [34])

Serious

Not Serious

Not Serious

Serious

Likely

16

−1.01 (−2.00 to −0.02)

VERY LOW

Activity limitation ST (1)

(Moret 1998 [34])

Serious

Not Serious

Not Serious

Serious

Likely

16

−0.56 (−1.50 to 0.39)

VERY LOW

Vertical Traction + Medications VS Medications

Pain ST (1)

(Khani 2015 [33])

Not Serious

Not Serious

Not Serious

Serious

Likely

50

−1.13 (−1.72 to −0.54)

LOW

  1. a RoB was considered “serious” in case of high risk of bias
  2. bImprecision was considered “serious” in case of one level (− 1) downgrading
  3. c Publication bias was not excluded, therefore it was considered sufficient for downgrading the quality of evidence
  4. d Effect size: Treatment effects favoring conservative intervention assigned negative Hedges standardized mean difference (SMD) values. ST = Short term
  5. e Prasad and colleagues recruited 26 patients, 24 of them were randomized, and 22 were eligible for assessment, but data on only 19 patients were published for the outcomes pain and activity limitation. For this reason, only 19 participants were considered included