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Table 7 Evidence profile of quality of life of institutionalized and non-institutionalized elderly for WHOQOL-BREF questionnaire

From: Does the institutionalization influence elderly’s quality of life? A systematic review and meta–analysis

Certainty assessment

Summary of findings

№ of participants

(studies)

Follow-up

Risk of bias

Inconsistency

Indirectness

Imprecision

Publication bias

Overall certainty of evidence

Study event rates (%)

Anticipated absolute effects

With NIE

With IE

Risk with NIE

Risk difference

with IE

WHOQOL-BREF – Overall

 5044 (5 observational studies)

not serious

serious a

not serious

not serious

all plausible residual confounding would suggest spurious effect, while no effect was observed

LOW

3157

1887

SMD 0.69 lower(0.93 lower to 0.46 lower)

WHOQOL-BREF - General Health

 564 (3 observational studies)

very serious b

very serious a,c

not serious

serious d

strong associationall plausible residual confounding would suggest spurious effect, while no effect was observed

VERY LOW

425

139

SMD 0.24 lower(1.0 lower to 0.52 higher)

WHOQOL-BREF - Physical Health

 1120 (5 observational studies)

not serious

very serious a,c

not serious

not serious

all plausible residual confounding would suggest spurious effect, while no effect was observed

VERY LOW

683

437

SMD 0.69 lower(1.17 lower to 0.22 lower)

WHOQOL-BREF - Psychological Health

 1120 (5 observational studies)

not serious

very serious a,c

not serious

serious d

all plausible residual confounding would suggest spurious effect, while no effect was observed

VERY LOW

683

437

SMD 0.82 lower(1.4 lower to 0.24 lower)

WHOQOL-BREF - Social relationship

 1120 (5 observational studies)

serious e

serious a

not serious

serious d

all plausible residual confounding would suggest spurious effect, while no effect was observed

VERY LOW

683

437

SMD 0.88 lower(1.46 lower to 0.29 lower)

WHOQOL-BREF - Environmental area

 1120 (5 observational studies)

serious f

serious a

not serious

serious d

all plausible residual confounding would suggest spurious effect, while no effect was observed

VERY LOW

683

437

SMD 0.66 lower(1.26 lower to 0.07 lower)

  1. Notes: SMD Standard mean difference, a Considerable heterogeneity; b Only studies with some risk of bias were included in this analysis; c There is wide variation in the effect estimates across studies with little or no overlap of confidence intervals associated with the effect estimates; d Upper and lower confidence limit crosses the effect size were greater than 0.5; e Effect and significance (p value) change after exclusion of studies with risk of bias (SMD -0.16 [−0.35, 0.03] p = 0.09); f Effect and significance (p value) change after exclusion of studies with risk of bias (SMD -0.10 [− 0.29, 0.09] p = 0.3)