Table 4.

Summary of findings of GRADE analysis for network meta-analysis

Patient or population: VUR grades II–IV Setting: various treatment modalities in children with VUR grade II–IV Interventions: surgical, endoscopic and conservative treatment Comparison: antibiotic prophylaxis Outcome: UTI recurrence				Network geometry*
Total studies: 9 RCTs Total participants: 1013	NMA estimate effect† (95% CI)	NMA Certainty in the evidence	Ranking‡ (P-score)	Interpretation
Surgical treatment  (Sx Rx)	−0.26 (−0.54 to 0.02)	Moderate§	0.85	Probably superior
Antibiotic prophylaxis  (AbxP)	Reference comparator	Reference comparator	0.43	Reference comparator
Endoscopic treatment  (Endo Rx)	0.2 (−1.41 to 1.81)	High	0.38	Probably inferior
Conservative treatment  (No AbxP)	0.15 (−0.45 to 0.75)	High	0.31	Probably inferior

GRADE Working Group grades of evidence.

High certainty: we are very confident that the true effect lies close to that of the estimate of the effect.

Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.

Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect.

Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect.

*Lines represent direct comparisons.

†Network estimate effects are reported as Log OR and the results are expressed in 95% CI since the frequentist model has been conducted.

‡Ranking is calculated by P-score by netrank function.

§Unclear explanation of randomisation process in two studies and some missing data in one study.

RCTs, randomised controlled trials; UTI, urinary tract infection; VUR, vesicoureteral reflux.