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Table 3 GRADE analysis and assessment of quality of evidence

From: Electromagnetic-guided versus endoscopic placement of post-pyloric feeding tubes: a systematic review and meta-analysis of randomised controlled trials

Quality assessment

Summary of findings

No of patients

Effect

Quality

No of studies

Design

Limitations

Inconsistency

Indirectness

Imprecision

Other considerations

EM

ENDO

Relative (95% CI)

Absolute

Procedure success rate

4

randomised trials

seriousa

no serious inconsistency

no serious indirectness

no serious imprecision

none

237/287 (82.6%)

207/249 (83.1%)

RR 0.97 (0.91 to 1.03)

25 fewer per 1000 (from 75 fewer to 25 more)

MODERATE

87.2%

26 fewer per 1000 (from 78 fewer to 26 more)

Need for reinsertion

2

randomised trials

seriousa

no serious inconsistency

no serious indirectness

no serious imprecision

none

41/148 (27.7%)

44/133 (33.1%)

RR 0.84 (0.59 to 1.2)

53 fewer per 1000 (from 136 fewer to 66 more)

MODERATE

33.3%

53 fewer per 1000 (from 137 fewer to 67 more)

Number of attempts

2

randomised trials

seriousa

seriousb

no serious indirectness

no serious imprecision

none

125

104

-

MD 0.23 lower (0.99 lower to 0.53 higher)

LOW

Placement-related complications

4

randomised trials

seriousa

no serious inconsistency

no serious indirectness

no serious imprecision

none

18/287 (6.3%)

18/249 (7.2%)

RR 0.78 (0.41 to 1.49)

16 fewer per 1000 (from 43 fewer to 35 more)

MODERATE

6.5%

14 fewer per 1000 (from 38 fewer to 32 more)

Tube-related complications

2

randomised trials

seriousa

no serious inconsistency

no serious indirectness

no serious imprecision

none

57/161 (35.4%)

50/154 (32.5%)

RR 1.08 (0.82 to 1.44)

26 more per 1000 (from 58 fewer to 143 more)

MODERATE

33.1%

26 more per 1000 (from 60 fewer to 146 more)

Insertion time

4

randomised trials

seriousa

seriousb

no serious indirectness

no serious imprecision

none

287

249

-

MD 4.3 higher (0.2 to 8.39 higher)

LOW

Total procedure time

2

randomised trials

seriousa

seriousb

no serious indirectness

no serious imprecision

none

161

154

-

MD 18.09 lower (38.66 lower to 2.47 higher)

LOW

Patient discomfort

2

randomised trials

seriousa

no serious inconsistency

no serious indirectness

no serious imprecision

none

161

154

-

MD 1.28 higher (0.46 to 2.1 higher)

MODERATE

Patient recommendation

3

randomised trials

seriousa

seriousb

no serious indirectness

no serious imprecision

none

243

227

-

MD 1.67 higher (0.24 to 3.1 higher)

LOW

Length of hospital stay

2

randomised trials

seriousa

no serious inconsistency

no serious indirectness

no serious imprecision

none

161

154

-

MD 1.57 higher (0.33 lower to 3.47 higher)

MODERATE

ICU mortality

3

randomised trials

seriousa

no serious inconsistency

no serious indirectness

no serious imprecision

none

28/205 (13.7%)

28/176 (15.9%)

RR 0.8 (0.5 to 1.29)

32 fewer per 1000 (from 80 fewer to 46 more)

MODERATE

20%

40 fewer per 1000 (from 100 fewer to 58 more)

In-hospital mortality

3

randomised trials

seriousa

no serious inconsistency

no serious indirectness

no serious imprecision

none

39/205 (19%)

36/176 (20.5%)

RR 0.87 (0.59 to 1.28)

27 fewer per 1000 (from 84 fewer to 57 more)

MODERATE

27.5%

36 fewer per 1000 (from 113 fewer to 77 more)

Total costs

3

randomised trials

seriousa

seriousb

no serious indirectness

no serious imprecision

none

243

227

-

SMD 1.8 lower (3.96 lower to 0.36 higher)

LOW

  1. aBlinding of participants and personnel are impossible in all RCTs
  2. bStatistical heterogeneity between RCTs