GRADE analyses: adjunctive Peony-Glycyrrhiza decoction for antipsychotic-induced hyperprolactinaemia
| Outcomes | Subjects | Risk of bias | Inconsistency | Indirectness | Imprecision | Publication bias | Large effect | Overall quality of evidence* |
| Prolactin level | 380 | No | Serious† | No | No | Serious‡ | Large§ | +/+/+/− Moderate |
| PANSS total scores | 403 | No | No | No | No | No | No | +/+/+/+ High |
| Discontinuation due to any reason | 330 | No | No | No | No | No | No | +/+/+/+ High |
| TESS total scores | 187 | Serious¶ | Serious† | No | No | Serious‡ | No | +/−/−/− Very low |
| Akathisia | 190 | Serious¶ | No | No | No | Serious** | No | +/+/−/− Low |
| Constipation | 190 | Serious¶ | No | No | No | Serious** | No | +/+/−/− Low |
| Headache | 190 | Serious¶ | No | No | No | Serious** | No | +/+/−/− Low |
*GRADE Working Group grades of evidence: high quality: further research is very unlikely to change our confidence in the estimate of effect; moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate; low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate; very low quality: we are very uncertain about the estimate.
†Meta-analytic results presented a serious inconsistency when I 2 values were greater than 50% or p<0.1 in the Q statistics.
‡For continuous outcomes, N<400.
§Studies with large effects provided increased quality of evidence. Large effects=effect size ≥0.8.
¶All studies reported as having a serious bias used an open-label method, only mentioned random allocation without describing the method and withdrawal from the study.
**For dichotomous outcomes, N<300.
GRADE, Grading of Recommendations Assessment, Development and Evaluation; PANSS, Positive and Negative Syndrome Scale; TESS, Treatment Emergent Symptom Scale.