Table 5.
GRADEpro summary: DBS compared to ODT in Parkinson's disease
| Certainty assessment | № of patients | Effect | Certainty | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| N° of studies | Study design | Risk of bias | Inconsistency | Indirectness | Imprecision | DBS | NO DBS | (95% CI) | ||||||||||
| Delayed Recall (DBS vs. ODT)—follow up: range 1 years to 3 years | ||||||||||||||||||
| 5 | randomized trials | serious a | not serious | not serious | not serious | 200 | 130 |
SMD 0.4 SD lower (0.75 lower to 0.05 lower) |
⨁⨁⨁◯ MODERATE |
|||||||||
| Phonemic fluency (DBS vs. PD)—follow up: range 1 years to 3 years | ||||||||||||||||||
| 8 | randomized trials | serious a | not serious | not serious | not serious | 256 | 183 |
SMD 0.56 SD lower (0.79 lower to 0.33 lower) |
⨁⨁⨁◯ MODERATE |
|||||||||
| Stroop Color and Word (DBS vs. PD)—follow up: range 1 years to 3 years | ||||||||||||||||||
| 5 | randomized trials | serious a | not serious | not serious | not serious | 182 | 117 |
SMD 0.45 SD lower (0.74 lower to 0.15 lower) |
⨁⨁⨁◯ MODERATE |
|||||||||
| Semantic Fluency (DBS vs. PD)—follow up: range 1 years to 3 years | ||||||||||||||||||
| 7 | randomized trials | serious a | not serious | not serious | not serious | 217 | 139 |
SMD 0.53 SD lower (0.78 lower to 0.29 lower) |
⨁⨁⨁◯ MODERATE |
|||||||||
ODT, optimal drug therapy (control group), CI Confidence interval, SMD Standardized mean difference (Hedges’g), STN subthalamic nucleus, GPi globus pallidus pars interna, DBS deep brain stimulation
GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect
Moderate quality: The authors believe that the true effect is probably close to the estimated effect
Low quality: Further research is very likely to have an important impact on our confidence in the estimated effect and could change the estimate
Very low quality: We are very uncertain about the estimate
Downgraded explanations
aDowngraded as there were serious limitations identified in the risk of bias, since not all the studies were RCTs