Table 1.  Grading of Recommendations Assessment, Development, and Evaluation (GRADE) summary of 25 randomized controlled trials (RCTs) comparing auricular acupressure plus antihypertensive drugs (AAPADs) to antihypertensive drugs (ADs) alone in hypertension patients.
Patient or population: patients with hypertensionSettings: inpatients/outpatientsIntervention: AAPADComparison: AD
Outcomes   Illustrative comparative risks a (95% CI)   Relative effect(95% CI)   No. of participants(studies)   Quality of the evidence(GRADE)   Comments
Assumed risk  Corresponding risk
AD   AAPAD
SBP change magnitude between baseline and post-intervention  The mean SBP change magnitude between baseline and post-intervention in the control groups was 135.73  The mean SBP change magnitude between baseline and post-intervention in the intervention groups was 5.06 lower (6.76 to 3.36 lower)   929(10 studies)  ⊕⊕⊕⊝Moderateb
DBP change magnitude between baseline and post-intervention  The mean DBP change magnitude between baseline and post-intervention in the control groups was 84.75  The mean DBP change magnitude between baseline and post-intervention in the intervention groups was 5.3 lower (6.27 to 4.33 lower)   929(10 studies)  ⊕⊕⊕⊝Moderateb
Efficacy rate   Study population  RR 1.22 (1.17–1.26)  2017 (21 studies)  ⊕⊕⊝⊝Lowb,c
731 per 1000  892 per 1000 (855–921)
Moderate
740 per 1000  903 per 1000 (866–932)
CI: Confidence interval; DBP: diastolic blood pressure; RR: risk ratio; SBP: systolic blood pressure; ROB: risk of bias.
GRADE Working Group grades of evidence: High quality: further research is very unlikely to change our confidence in the estimate of effect; Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate; Low quality: 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; Very low quality: we are very uncertain about the estimate.
a  The basis for the assumed risk (e.g. the median control group risk across studies) is provided in these footnotes. The corresponding risk (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
b  According to the ROB graph (Supplementary Material Figure 1).
c  Funnel plot was asymmetrical.