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very low confidence in the effect estimate, very low quality of the evidence, very low strength of the evidence
Very low certainty of the evidence means that the likelihood is very high that the effect will be different enough from what the research found that it might affect a decision.
Judgements about the certainty of the evidence are based on factors that reduce the certainty (risk of bias, inconsistency, indirectness, imprecision, and reporting bias), and factors that increase the certainty, such as dramatic treatment effects.
There is very low certainty of the evidence when there are one or more factors that reduce the certainty of the evidence to the extent that the likelihood that the effect will be substantially different is very high.
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