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Table 3 Level of evidence assessment using GRADE approach for the outcomes

From: Oral and injectable Marsdenia tenacissima extract (MTE) as adjuvant therapy to chemotherapy for gastric cancer: a systematic review

Study Risk of bias Imprecision Inconsistency Indirectness Publication bias Level of evidence
Marsdenia tenacissima extract in adjutant with chemotherapy for management of gastric cancer
 Response to treatment -1 −0 − 0 − 0 − 1 Low
 Performance status −1 − 1 − 0 − 0 − 0 Low
Marsdenia tenacissima extract for reducing adverse effect of chemotherapy
 Leukopenia −1 −0 − 0 − 0 − 0 Moderate
 Thrombocytopenia − 1 − 0 − 0 − 0 − 0 Moderate
 Anemia −1 − 1 − 0 − 0 −0 Low
 Nausea/vomiting − 1 −0 −0 − 0 −0 Moderate
 Diarrhea −1 − 1 −0 −0 − 0 Low
 Constipation −1 −2 −0 −0 − 0 Very low
 Hepatic injury −1 −0 −0 − 0 −0 Low
 Kidney injury −2 − 2 −0 −0 − 0 Very low
 Peripheral neurotoxicity −1 −0 −0 − 0 −0 Moderate
 Oral mucosal lesions −1 − 1 −0 −0 − 0 Low
  1. Note: In GRADE instrument, the level of evidence of outcomes is judged as high, moderate, low, and very low if the total score is “-0”, “-1”, “-2”, and “≥ −3”, respectively