22. Patient Global Impression of Change much/very much improved summary of findings.

Estimates of effects, credible intervals, and certainty of the evidence of antidepressants on Patient Global Impression of Change in people with chronic pain
Bayesian network meta‐analysis summary of findings table
Patient or population: people with chronic pain Interventions: desvenlafaxine high dose (> 50 mg); duloxetine standard dose (60 mg) and high dose (> 60 mg); esreboxetine standard dose (4‐8 mg) and high dose (> 8 mg); milnacipran standard dose (100 mg) and high dose (> 100 mg) Comparator (reference): Placebo Outcome: Patient Global Impression of Change (PGIC) – people reporting much or very much improved (i.e. 1 or 2 on the 7‐point PGIC scale) Direction: higher is better (i.e. more people reporting much or very much improved from baseline)
Total studies: 12 Total participants: 6995	Relative effect (OR and 95% CI)	Anticipated absolute effect (event rate)*			Certainty of the evidence (CINeMA)	Ranking** (2.5% to 97.5% credible interval)	Interpretation of findings
		With placebo	With intervention	Difference
Duloxetine standard dose RCTs: 3 Participants: 974	2.29 (1.98 to 2.60)	215 per 1000 106/493	382 per 1000 184/481	170 more per 1000	Moderatea	2 (1 to 6)	Equivalent to NNTB of 5.9
Duloxetine high dose RCTs: 2 Participants: 567	2.03 (1.62 to 2.44)	250 per 1000 70/280	404 per 1000 113/287	154 more per 1000	Very lowa,e	4 (1 to 7)	Equivalent to NNTB of 6.5
Milnacipran high dose RCTs: 3 Participants: 2057	1.99 (1.77 to 2.21)	282 per 1000 280/992	439 per 1000 480/1065	157 more per 1000	Lowa	4 (1 to 7)	Equivalent to NNTB of 6.4
Milnacipran standard dose RCTs: 3 Participants: 2098	1.95 (1.73 to 2.17)	303 per 1000 320/1055	459 per 1000 462/1043	156 more per 1000	Moderatea	4 (1 to 7)	Equivalent to NNTB of 6.4
Esreboxetine standard dose RCTs: 1 Participants: 811	1.79 (1.44 to 2.14)	291 per 1000 80/275	423 per 1000 226/536	133 more per 1000	Very lowa,e	5 (1 to 7)	Equivalent to NNTB of 7.5
Esreboxetine high dose RCTs: 1 Participants: 550	1.63 (1.24 to 2.02)	291 per 1000 80/275	401 per 1000 110/275	110 more per 1000	Very lowa,e	6 (2 to 8)	Equivalent to NNTB of 9.1
Desvenlafaxine high dose RCTs: 1 Participants: 528	1.01 (0.58 to 1.44)	429 per 1000 54/126	431 per 1000 173/402	2 more per 1000	Very lowa,b,e	8 (6 to 9)	Not significantly different from placebo
Network meta‐analysis‐summary of findings table definitions * Anticipated absolute effect. Anticipated absolute effect compares two risks by calculating the difference between the risk of the intervention group with the risk of the control group. ** Mean rank and credible intervals are presented. CI: confidence interval; CINeMA: Confidence in Network Meta‐Analysis; NNTB: number needed to treat for an additional beneficial outcome; OR: odds ratio; PGIC: Patient Global Impression of Change; RCT: randomised controlled trial; VAS: visual analogue scale The number of participants for each antidepressant reflects the total number of participants taking the antidepressant or placebo from the studies in the network meta‐analysis.
CINeMA grades of confidence in the evidence High: further research is unlikely to change our confidence in the estimate of effect. Moderate: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low: we are very uncertain about the estimate.

^aDowngraded due to within‐study bias.
^bDowngraded due to imprecision in the estimate.
^cDowngraded due to heterogeneity in the estimate.
^dDowngraded due to incoherence in the network.
^eDowngraded due to a small number of trials and participants; we cannot draw reliable conclusions.