NutriGrade Scoring System

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Study Title


Outcome


Exposure


1. Risk of bias/ study quality/ study limitations


No quantitative and descriptive information available
Risk of bias
Ascertainment of exposure
Adjusted basic & outcome relevant model
Assessment of outcome
Adequacy of follow-up duration

Study quality

2. Precision


< 500 events OR ≥ 500 events but 95% CI overlaps the null, and includes important benefit (RR: <0.8) or harm (RR: >1.2)
≥ 500 events and the 95% CI excludes the null values; ≥500 events but 95% CI overlaps the null, and excludes important benefit (RR: <0.8) or harm (RR: >1.2)

3. Heterogeneity


≤ 5 studies (0 P)
6-9 studies ≥ 10 studies
I2 (H2 and/or tau2)
I2 < 40%
I2 ≥ 40% Modelling detected heterogeneity with random effects model
None of the above
Exploring detected heterogeneity with subgroup analysis or meta-regression
Sensitivity analyses with higher levels of heterogeneity
95%CIs for I2

4. Directness


surrogate markers; differences in population; differences in intervention; network meta-analysis
hard clinical outcome; no important differences in population or intervention

5. Publication bias


< 5 studies OR evidence for severe bias with test or plot OR publication bias not assessed / reported
No evidence for publication bias with test or plot (5-9 studies) OR evidence for moderate / small amount of publication bias with test or plot
No evidence for publication bias with test or plot (≥10 studies)

6. Funding bias


Industry funding OR conflict of interest
Private institutions, foundations, non-governmental organizations
Academic institutions, research institutions

7. Effect size


No effect
Moderate effect size (HR/RR: <0.80-0.50 or >1.2-2.00)
Large effect size (HR/RR: <0.50 or >2.00)

8. Dose-response


No dose-response relationship (corresponding statistical test non- significant)
Linear and/ or non-linear dose-response relationship (corresponding statistical test significant)



Total Score:





Grading scoring system meta-evidence:
Nutrigrade-Score Meta-evidence Explanation
≥ 8 points High There is high confidence for the effect estimate, and further research probably will not change the confidence in the effect estimate.
6 to 7.99 points Moderate There is moderate confidence for the effect estimate, further research could add evidence on the confidence and may change the effect estimate.
4 to 5.99 points Low There is low confidence for the effect estimate, further research will provide important evidence on the confidence and likely change the effect estimate.
0 to 3.99 points Very low There is very low confidence for the effect estimate; meta-evidence is very limited and uncertain.