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Table 2 Summary of findings: Tai Chi plus usual care compared to usual care for psychological well-being and QoL in people with CVD and risk factors

From: Does tai chi improve psychological well-being and quality of life in patients with cardiovascular disease and/or cardiovascular risk factors? A systematic review

Outcomes

Anticipated absolute effects* (95% CI)

Relative effect (95% CI)

№ of participants (studies)

Certainty of the evidence (GRADE)

Risk with Usual care

Risk with Tai Chi + Usual care

Safety

16 per 1000

8 per 1000 (3 to 20)

RR 0.50 (0.21 to 1.20)

248 (5 RCTs)

VERY LOW a, b

Stress assessed with: PSS-14

The mean stress was 3.99 scores

MD 0.76 scores lower (1.02 lower to 0.5 lower)

61 (1 RCT)

VERY LOW c, d

Anxiety assessed with: HADS-A & SAS

SMD 2.13 lower (2.55 lower to 1.7 lower)

410 (3 RCTs)

LOW c

Depression assessed with: HADS-D, GDS, BDI, SDS & CES-D

SMD 0.85 SD lower (1.52 lower to 0.17 lower)

675 (6 RCTs)

LOW a, e

Quality of Life - Mental Health assessed with: SF-36

The mean quality of Life - Mental Health was 48.1 - 87.01 scores

MD 7.86 scores higher (5.2 higher to 10.52 higher)

1124 (11 RCTs)

LOW c

Quality of Life assessed with: Total score of SF-36

The mean quality of Life was 61.5 - 82.96 scores

MD 18.91 scores higher (12.8 higher to 25.03 higher)

369 (3 RCTs)

LOW c

  1. *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI)
  2. CI Confidence interval, RR Risk ratio, MD Mean difference, SMD Standardised mean difference
  3. GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect
  4. Explanations:
  5. a. Moderate risk of bias (RoB), and no sensitivity analysis of only low RoB studies was conducted or if conducted, the effect estimates were unstable
  6. b. Optimal information size (OIS) is not met, 95% CI overlaps no effect but fails to include both important benefit and harm
  7. c. High RoB, and no sensitivity analysis by excluding high RoB studies was conducted or if conducted, the effect estimates were unstable
  8. d. OIS is not met, 95% CI excludes overlap no effect
  9. e. I2 > 75% & all studies favour one direction (visual inspection)