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Table 1 Summary of findings for literature quality of evidence

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.