GRADE evidence profile and summary of findings for use of rapid approaches for improving health outcomes
| Outcomes | Effects of rapid testing approaches on HIV outcomes | Relative effect (95% CI) | Anticipated absolute effect with control | Risk difference with intervention | Number of participants (studies) | Quality of the evidence (GRADE) |
|---|---|---|---|---|---|---|
| Uptake of testing Follow-up: 12–36 months | Three RCTs included in the analysis provided consistent point estimates showing uptake of testing was significantly better among participants randomised to rapid testing approaches | RR=2.95 (1.69 to 5.16) | 145 more per 1000 | 282 cases more per 1000 (100–602) | 80 400 (4 studies) 18 350* | ⊕⊕⊕⊝ Moderate† |
| Receipt of results Follow-up: 12–24 months | Two RCTs reported rapid approaches resulted in higher receipt of HIV test results. However due to the heterogeneity-variations in population characteristics, the pooled estimates were not statistically significant | RR=2.14 (1.04 to 4.24) | 213 more per 1000 | 243 cases per 1000 (17–691) | 18 426 (3 studies) 4680* | ⊕⊕⊕⊝ Moderate† |
| Combined effect of repeat testing Follow-up: 36 months | One large Cluster RCT found a very large effect for this outcome with participants randomised to rapid testing approaches twice more likely to have repeat HIV tests | RR=2.28 (0.35 to 15.07) | 97 more per 1000 | 124 cases per 1000 (63 fewer–1000 more) | 10 706 (1 study) | ⊕⊕⊕⊝ Moderate† |
| HIV incidence Follow-up: 36 months | HIV incidence did decrease in intervention clusters compared with control clusters, but this effect was not statistically significant | RR=0.89 (0.63 to 1.24) | 81 more per 1000 | 9 cases per 1000 (30 fewer–19 more) | 115 300 7189* (1 study) | ⊕⊕⊝ Low‡, § |
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.
*Adjusted sample size after applying the intracluster correlation coefficient.
†Outcome of HIV incidence was downgraded because allocation concealment was unclear, blinding of intervention not possible and inability to determine blinding of researchers.
‡Outcome of HIV incidence was downgraded because allocation concealment was unclear, blinding of intervention not possible and inability to determine blinding of researchers and imprecision of estimates.
§Number of participants included in the analysis is not available from the abstracts.
RCT, randomised controlled trial; RR, relative risk.