Chapter 4 62 GRADE We used the GRADE prognostic factor framework to assign the strength and quality of evidence of association of prognostic factors with adherence. This process applies eight criteria that can upgrade or downgrade the quality of evidence supporting a prognostic factor and allows for evidence of a review of prognostic factors to be efficiently summarized for end-users [26]. These criteria were applied as described by Huguet et al. [26]. Prospective or retrospective cohort studies that test a fully developed hypothesis and conceptual framework without serious study limitations, and confirmatory studies without serious limitations constitute highquality evidence on prognosis [26]. All statistical analyses were performed in R version 4.0.3. [27] using the {meta} package [28]. Results Included studies The PRISMA flowchart in Figure 1 shows the selection procedure. The search strategy initially identified 9138 studies; 5674 remained after duplicates were removed. Because there was less than 5% difference between the results of ER and AD, ER completed the title and abstract screening. Following title and abstract screening, 122 studies were assessed for full-text eligibility and 65 studies were excluded. The main reasons for exclusion were, no quantitative data, unsuitable study outcomes (no predictive factors of adherence), unsuitable study design (review or protocol) or it concerned a PhD-thesis of which no full text article was available or could not be obtained through the author (Figure 1). We included the finally remaining 57 studies in this systematic review, of which two studies were translated from Korean into English [29, 30]. No additional studies were identified through hand-searching or a search in the grey literature.
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