WHO/HIV/2013.76
© World Health Organization 2013
GRADE Table: PICO b – Should community health workers maintain ART among people living with HIV receiving antiretroviral therapy compared to doctors? Author(s): Tamara Kredo, Moses Bateganya, Elizabeth D. Pienaar, Folasade B Adeniyi Date: 2012-10-22 Question: Should community health workers maintain ART among people living with HIV receiving antiretroviral therapy compared to doctors? Settings: Uganda Bibliography: Jaffar 2009, Kipp 2010.
Quality assessment
No. of patients
Effect Quality Absolute Importance
No. of studies
Design
Risk of bias
Doctor versus Other community health Relative Inconsistency Indirectness Imprecision Control considerations worker for maintaining (95% CI) antiretroviral therapy
Death (RCTs) 1 randomized no trials serious risk of bias no serious inconsistency no serious indirectness serious1 none 36/330 (10.9%) 25/229 RR 1 (10.9%) (0.62 to 1.62) 0 fewer per CRITICAL ⊕⊕⊕Ο 1000 (from 41 MODERATE fewer to 68 more)
Lost to care (RCTs) (follow-up 12 months) 1 randomized no trials serious risk of bias no serious inconsistency no serious indirectness serious1 none 3/330 (0.91%) 4/229 (1.7%) RR 0.52 (0.12 to 2.3) 8 fewer per CRITICAL ⊕⊕⊕Ο 1000 (from 15 MODERATE fewer to 23 more)
Death or lost to care (RCTs) (follow-up 12 months) 1 randomized no trials serious risk of bias no serious inconsistency no serious indirectness serious1 none 39/330 (11.8%) 29/229 RR 0.93 (12.7%) (0.6 to 1.46) 9 fewer per CRITICAL ⊕⊕⊕Ο 1000 (from 51 MODERATE fewer to 58 more)
Downgraded by one for imprecision. This cluster-randomized trial was adjusted for design effect having assumed an intracluster correlation coefficient (0.05), since none was provided in the report. The resulting 95% confidence interval included appreciable benefit and harm.
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This work was commissioned by the World Health Organization and carried out by The University of California, San Francisco (UCSF), Cochrane Review Group on HIV/AIDS 1