1. Dietary habits |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
1.14 [0.28, 2.01] |
Low |
It may improve dietary habits |
0 |
0 |
[, ] |
N/A |
1.0 |
1.14 [0.28, 2.01] |
Low |
2. Physical activity |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
-0.2 [-0.92, 0.52] |
Very low |
It may result in little to no difference in physical activity |
0 |
0 |
[, ] |
NA |
1.0 |
-0.2 [-0.92, 0.52] |
Low |
3. Adherence / Medication (or other treatment) adherence |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
0.25 [-0.93, 1.44] |
Very low |
It may result in little to no difference in adherence |
1 |
241 |
0.14 [-1.8, 2.08] |
Low |
1.0 |
0.33 [-1.18, 1.83] |
Low |
4. Weight (management) / Waist size |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
-3.5 [-6.0, -1.0] |
Low |
It may result in little to no difference in waist size (cm) |
1 |
146 |
-3.5 [-6.0, -1.0] |
Low |
0.0 |
NA [NA, NA] |
NA |
5. Blood-pressure / Diastolic pressure |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
-2.26 [-4.22, -0.31] |
Very low |
It may result in little to no difference in diastolic blood pressure(mmHg) but the evidence is very uncertain |
4 |
652 |
-1.9 [-3.98, 0.18] |
Low |
1.0 |
-4.92 [-10.53, 0.69] |
Low |
6. Blood-pressure / Systolic pressure |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
-3.91 [-7.04, -0.78] |
Very low |
It may increase systolic blood pressure levels (mmHg) but the evidence is very uncertain |
5 |
652 |
-3.84 [-7.15, -0.53] |
Low |
1.0 |
-4.51 [-14.23, 5.22] |
Low |
7. Lipid profile / LDL-Cholesterol |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
2.91 [-2.25, 8.07] |
Low |
It may result in little to no difference in LDL levels (mg/dL) |
2 |
256 |
7.26 [1.26, 13.27] |
Low |
1.0 |
-9.33 [-19.4, 0.74] |
Low |
8. Weight (management) / BMI - Body Mass Index |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
-0.3 [-0.83, 0.23] |
Low |
It may result in little to no difference in body mass index (kg/m²) |
5 |
720 |
-0.3 [-0.83, 0.23] |
Low |
0.0 |
NA [NA, NA] |
NA |
9. Lipid profile / HDL-Cholesterol (mmol) |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
3.15 [0.58, 5.71] |
Low |
It likely results in a large decrease in HDL levels (mmol/L) |
3 |
531 |
-0.36 [-3.22, 2.51] |
Moderate |
1.0 |
17.29 [11.53, 23.05] |
Moderate |
10. Weight (management) / Weight (Kgs/lbs) |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
-0.61 [-2.01, 0.78] |
Low |
It may result in little to no difference in weight (kgs) |
3 |
437 |
-0.71 [-2.13, 0.71] |
Low |
1.0 |
2.24 [-5.36, 9.84] |
Low |
11. Lipid profile / Triglycerides |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
0.11 [-0.45, 0.66] |
Moderate |
It likely results in little to no difference in triglycerides (mmol/L) |
3 |
324 |
0.32 [-0.32, 0.96] |
Moderate |
1.0 |
-0.52 [-1.61, 0.57] |
Moderate |
12. Lipid profile / Total cholesterol |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
-0.53 [-6.26, 5.19] |
Very low |
It may result in little to no difference in total cholesterol (mg/dL) |
3 |
665 |
1.09 [-5.04, 7.23] |
Low |
1.0 |
-11.6 [-27.6, 4.4] |
Low |
13. HbA1C / Glycated hemoglobin (HbA1c) |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
-0.78 [-1.0, -0.57] |
Low |
It may decrease HbA1C levels (%) |
8 |
1390 |
-0.74 [-1.0, -0.49] |
Low |
3.0 |
-0.88 [-1.28, -0.47] |
Low |
Footnotes per outcome:
1) a) Number of studies included in the network: 30 RCTs; Number of studies directly comparing the intervention with usual care: 0 RCT(s) (N=0); Number of comparison(s) informing the indirect estimate: 1 comparison(s). The range of follow up was from 1 to 24 months for the studies included in the whole network; b) We rated down the certainty of evidence due to serious imprecision 2) a) We rated down the certainty of evidence due to very serious risk of bias and very serious imprecision; b) Number of studies included in the network: 64 RCTs; Number of studies directly comparing the intervention with usual care: 0 RCT(s) (N=0); Number of comparison(s) informing the indirect estimate: 1 comparison(s). The range of follow up was from 1 to 24 months for the studies included in the whole network. 3) a) Number of studies included in the network: 55 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=120); Number of comparison(s) informing the indirect estimate: 1 comparison(s). The range of follow up was from 1 to 24 months for the studies included in the whole network. The range of follow-up was 12 months in the studies directly comparing the self-management intervention versus usual care.; b) We rated down the certainty of evidence due to very serious imprecision 4) a) Number of studies included in the network: 81 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=97); Number of comparison(s) informing the indirect estimate: 0 comparison(s). The range of follow up was from 1 to 36 months for the studies included in the whole network. The range of follow-up was 6 months in the studies directly comparing the self-management intervention versus usual care.; b) We rated down the certainty of evidence due to very serious risk of bias and very serious risk of bias 5) a) Number of studies included in the network: 211 RCTs; Number of studies directly comparing the intervention with usual care: 4 RCT(s) (N=347); Number of comparison(s) informing the indirect estimate: 1 comparison(s). The range of follow up was from 1 to 96 months for the studies included in the whole network. The range of follow-up was 6-36 months in the studies directly comparing the self-management intervention versus usual care.; b) We rated down the certainty of evidence due to very serious risk of bias and serious imprecision 6) a) We rated down the certainty of evidence due to serious imprecision and very serious risk of bias; b) Number of studies included in the network: 233 RCTs; Number of studies directly comparing the intervention with usual care: 5 RCT(s) (N=347); Number of comparison(s) informing the indirect estimate: 1 comparison(s). The range of follow up was from 1 to 96 months for the studies included in the whole network. The range of follow-up was 6-36 months in the studies directly comparing the self-management intervention versus usual care. 7) a) We rated down the certainty of evidence due to serious risk of bias and serious inconsistency; b) Number of studies included in the network: 171 RCTs; Number of studies directly comparing the intervention with usual care: 2 RCT(s) (N=150); Number of comparison(s) informing the indirect estimate: 1 comparison(s). The range of follow up was from 1 to 96 months for the studies included in the whole network. The range of follow-up was 6-36 months in the studies directly comparing the self-management intervention versus usual care. 8) a) We rated down the certainty of evidence due to very serious risk of bias; b) Number of studies included in the network: 231 RCTs; Number of studies directly comparing the intervention with usual care: 5 RCT(s) (N=380); Number of comparison(s) informing the indirect estimate: 0 comparison(s).The range of follow up was from 1 to 96 months for the studies included in the whole network. The range of follow-up was 6-36 months in the studies directly comparing the self-management intervention versus usual care. 9) a) We rated down the certainty of evidence due to serious risk of bias and serious incoherence; b) Number of studies included in the network: 162 RCTs; Number of studies directly comparing the intervention with usual care: 3 RCT(s) (N=291); Number of comparison(s) informing the indirect estimate: 1 comparison(s). The range of follow up was from 1 to 96 months for the studies included in the whole network. The range of follow-up was 6-36 months in the studies directly comparing the self-management intervention versus usual care. 10) a) Number of studies included in the network: 145 RCTs; Number of studies directly comparing the intervention with usual care: 3 RCT(s) (N=243); Number of comparison(s) informing the indirect estimate: 1 comparison(s). The range of follow up was from 1 to 51 months for the studies included in the whole network. The range of follow-up was 6 months in the studies directly comparing the self-management intervention versus usual care.; b) We rated down the certainty of evidence due to very serious risk of bias 11) a) Number of studies included in the network: 171 RCTs; Number of studies directly comparing the intervention with usual care: 3 RCT(s) (N=183); Number of comparison(s) informing the indirect estimate: 1 comparison(s). The range of follow up was from 1 to 96 months for the studies included in the whole network. The range of follow-up was 6-36 months in the studies directly comparing the self-management intervention versus usual care.; b) We rated down the certainty of evidence due to serious risk of bias 12) a) Number of studies included in the network: 176 RCTs; Number of studies directly comparing the intervention with usual care: 3 RCT(s) (N=357); Number of comparison(s) informing the indirect estimate: 1 comparison(s). The range of follow up was from 1 to 96 months for the studies included in the whole network. The range of follow-up was 6-12 months in the studies directly comparing the self-management intervention versus usual care.; b) We rated down the certainty of evidence due to very serious risk of bias and serious incoherence 13) a) We rated down the certainty of evidence due to serious risk of bias and serious inconsistency; b) Number of studies included in the network: 463 RCTs; Number of studies directly comparing the intervention with usual care: 8 RCT(s) (N=706); Number of comparison(s) informing the indirect estimate: 3 comparison(s). The range of follow up was from 1 to 96 months for the studies included in the whole network. The range of follow-up was 3-36 months in the studies directly comparing the self-management intervention versus usual care.
References of studies informing direct evidence:
3) Chung-2014 4) Sun-2008 5) Chao-2015Kopf-2014Murray-2017Sun-2008 6) Chao-2015Kopf-2014Murray-2017Sun-2008McLean-2008 7) Kopf-2014Sun-2008 8) Chao-2015, Kopf-2014, Luley-2011, Murray-2017, Sun-2008 9) Kopf-2014, Murray-2017, Sun-2008 10) Luley-2011, Schwedes-2002, Sun-2008 11) Kopf-2014, Luley-2011, Sun-2008 12) Murray-2017, Schwedes-2002, Sun-2008 13) Chung-2014, Farsaei-2011, Kopf-2014, Luley-2011, Murray-2017, Schwedes-2002, Sun-2008, Suriyawongpaisal-2016
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