From: Systematic review of the impact of heatwaves on health service demand in Australia
Quality factor | Rating | Rationale |
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 Risk of bias across studies | 0 | There is no substantial risk of bias across the body of evidence included in the review |
 Indirectness | 0 | The studies were directly related to the question of interest (PICOT) |
 Inconsistency | −1 | Studies were not always consistent regarding the magnitude and direction of effect of heatwaves. |
 Imprecision | −1 | Studies included sufficient participants. Some wide confidence intervals occurred specifically in the condition-specific data. |
 Publication bias | 0 | There was no substantial risk of publication bias across the body of evidence included in the review. |
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 Large magnitude of effect | 1 | Large magnitude of effect for condition specific studies. Results were unlikely to be explained by confounding alone. |
 Dose response | 1 | Dose-response relationship evident when multiple definitions of heatwaves were used. |
 Confounding minimizes effect | 0 | No evidence that residual confounding underestimated the effect. |