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Table 4 Evidence summary and GRADE analysis

From: Comparative effectiveness of cognitive behavioral therapy for insomnia: a systematic review

Comparison Outcome period (quantitative sleep measures) Conclusion Quantity and type of evidence Starting level of evidence strength Quality Inconsistency Directness Sparse or imprecise Reporting bias Strong or very strong association Dose-resp. Confounders would increase eff. Final level of evidence strength
CBT-I vs. benzodiazepines Short term Improved less with CBT-I 3 RCT High –2 –1 0 0 0 0 0 0 Very low
  Long term Improved more with CBT-I 3 RCT High –1 0 0 0 0 0 0 0 Moderate
CBT-I vs. non-benzodiazepines Short term Improved more with CBT-I 2 RCT High –1 0 0 0 0 0 0 0 Moderate
  Long term Improved more with CBT-I 1 RCT High –1 0 0 –1 0 0 0 0 Low
  1. Evidence assessed using methods of the GRADE Working Group [2628].
  2. Evidence strength ratings:
  3. High: Further research is very unlikely to change our confidence in the estimate of effect.
  4. Moderate: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
  5. Low: 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.
  6. Very low: Any estimate of effect is very uncertain.
  7. Short term outcomes typically 4 to 8 weeks, long-term outcomes typically 6 to 12 months.