Table 3

Quality of the evidence for the relationship between risk factors and specific soft tissue shoulder disorders according to the GRADE framework

Number of participantsNumber of casesNumber of studiesPhase of investigation
1=explorative
2/3=explanatory
Phase 1: ↓		Study limitations
Study quality majority of studies
<11/16: ↓		Inconsistency
I2>50% or
one study: ↓		Indirectness
Yes: ↓		Imprecision
CI effect size (<1 and >2, range >2)
Yes: ↓		Publication bias
Yes or unclear: ↓		Effect size
OR (95% CI)
Lower limit OR>2.0: ↑		Exposure-response gradient
(dose effect)
Majority of studies: ↑		Overall quality of evidence
Force exertion2 412 94516 19952Lower ‘risk of bias’66%↓ NoNoUnclear↓ 1.53
(1.25 to 1.87)		2/5Low
Arm elevation2 400 23114 84442Lower ‘risk of bias’50%NoNoUnclear↓ 1.91
(1.47 to 2.47)		2/4Moderate
Repetition2 410 70615 62032Lower ‘risk of bias’95%↓ NoNoUnclear↓ 1.42
(0.91 to 2.22)		1/3Low
Shoulder load2 397 99214 26522Lower ‘risk of bias’0%NoNoUnclear↓ 2.00
(1.90 to 2.10)		1/2Moderate
Hand-arm vibration2 387 95215 97342Lower ‘risk of bias’99%↓ NoNoUnclear↓ 1.34
(1.01 to 1.77)		1/4Low
Job demands50 841199632Lower ‘risk of bias’62%↓NoNoUnclear↓ 1.12
(1.01 to 1.25)		0/3Low
Social support38 96669232Lower ‘risk of bias’61%↓ NoNoUnclear↓ 1.05
(0.83 to 1.33)		0/3Low
Decision latitude13 439143922Lower ‘risk of bias’84%↓ NoNoUnclear↓ 1.08
(0.89 to 1.31)		0/2Low
Job control37 40255712Lower ‘risk of bias’One study↓ NoNoUnclear↓ 1.22
(1.00 to 1.50)		0/1Low
Job security7258412Lower ‘risk of bias’One study↓ NoNoUnclear↓ 1.12
(0.93 to 1.36)		0/1Low
Work with temporary workers6144512Lower ‘risk of bias’One study↓ NoYes↓ Unclear↓ 2.2
(1.2 to 4.2)		0/1Very low

  • GRADE, Grades of Recommendations, Assessment, Development and Evaluation. 

  • ↓ signifies a downgrade of quality of the evidence; ↑ signifies an upgrade of quality of the evidence.