Table 3 Certainty assessment (Factors)
Nº of studies | Study design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | Effect | Certainty |
|---|---|---|---|---|---|---|---|---|
Age: [38] Harrold, [39] Adams 2001, [35] Williams, [37] Stark | ||||||||
4 | observational studies | seriousa | seriousb | not serious | seriousc | all plausible residual confounding would reduce the demonstrated effect | Most studies showed increased workload with patient´s age | ⨁⨁◯◯ Low |
2 | observational studies | not seriousa | not serious | not serious | seriousd | all plausible residual confounding would reduce the demonstrated effect | Higher workload in man | ⨁⨁⨁⨁ High |
2 | observational studies | seriousa | not serious | Very seriouse,f | seriousa,c | all plausible residual confounding would reduce the demonstrated effect dose response gradient | Increased workload in patients with poorer functional status | ⨁⨁◯◯ Low |
Clinical diagnoses: [38] Harrold J, [28] Adams 2000, [29] Lee, [44] Trisolini, [35] Williams, [34] Cox, | ||||||||
6 | observational studies | seriousa | not serious | seriousf | seriousa,c | all plausible residual confounding would reduce the demonstrated effect | There is an association between workload and the number or type of clinical diagnoses of patients | ⨁⨁◯◯ Low |
2 | observational studies | seriousa | Not serious | Seriousf | Seriousc | all plausible residual confounding would reduce the demonstrated large effect | New admissions increased workload | ⨁⨁⨁◯ Moderate |
Rural environment: [39] Adams 2001 | ||||||||
1 | observational studies | not serious | not serious | not serious | not serious | strong association all plausible residual confounding would reduce the demonstrated effect dose response gradient | Living in a rural locale increased workload comparison to living in an urban locale | ⨁⨁⨁⨁ High |