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Table 6 GRADE assessment of included outcomes for PDRI and P-PASS

From: Risk indices predicting graft use, graft and patient survival in solid pancreas transplantation: a systematic review

Outcome

Risk index

Studies^

GRADE quality

Footnotes*

Interpretation

1-year pancreas survival

PDRI as a continuous score

4

⊕

VERY LOW

2 studies demonstrated an association with outcome

Downgraded for:

Outcomes differing between studies (INCONSISTENCY)

Very low quality evidence that PDRI as a continuous variable is associated with 1-year pancreas survival

 

PDRI as quintiles

4

⊕⊕

LOW

3 of 4 studies demonstrated an association with the outcome

Association with SPK transplants in 2 studies

Low quality evidence that PDRI in quartiles is associated with 1-year pancreas survival (particularly SPK transplants)

 

PDRI as categorical model (various risk groups)

5

⊕

VERY LOW

1 of 5 studies demonstrated an association with outcome

Downgraded for:

Differing PDRI risk groups (INDIRECTNESS)

Outcomes differing between studies (INCONSISTENCY)

Small total event rate < 300 (IMPRECISION)

Very low quality evidence that PDRI as a categorical model (by various risk groups) is associated with 1-year pancreas survival

1-year patient survival

PDRI as tertiles

1

⊕

VERY LOW

No association with outcome

Downgraded for:

Small number of studies (IMPRECISION)

Very low quality evidence that PDRI by tertiles is associated with 1-year patient survival

Donor pancreas acceptance

P-PASS < 17vs ≥ 17

4

⊕⊕

LOW

All studies demonstrated an association with outcome

Low quality evidence that P-PASS is associated with donor pancreas acceptance

  1. *No pooling of discrimination metrics or other effect estimates unless otherwise stated. All outcome evidence was downgraded at baseline due to the observational nature of the studies as well as their risk of bias
  2. PDRI pancreas donor risk index, P-PASS pre-procurement pancreas suitability score, SPK simultaneous pancreas-kidney transplant