Table 2.
Comparisons where the surgical treatment was superior to the drug treatment
| Surgical arm | Drug arm | Disease | Outcome | Treatment effect (95% CI) | GRADE assessment |
| Transmyocardial lazer revascularisation | Continued medication | Refractory angina | Angina reduction | OR=4.63 (3.43 to 6.25) | Low |
| Surgical excision | Imiquimod | BCC | Recurrence (3 years) | RR=0.1 (0.03 to 0.31) | Moderate |
| Recurrence (5 years) | RR=0.13 (0.05 to 0.36) | Moderate | |||
| Surgical excision | MAL-PDT | BCC | Recurrence (3 years) | RR=0.04 (0 to 0.61) | Low |
| Surgical excision | ALA-PDT | BCC | Recurrence (3 years) | RR=0.09 (0.02 to 0.38) | Moderate |
| Recurrence (5 years) | RR=0.08 (0.02 to 0.34) | Moderate | |||
| Laparoscopic fundoplication | Protein pump inhibitors | GERD | GORD-specific QOL (<1 years) | SMD=0.58 (0.46 to 0.7) | Low |
| Lateral internal sphincterotomy | Medical therapy (mainly GTN and Botox) | Anal fissure | Non-healing (persistence or recurrence) 2 months. | OR=0.11 (0.06 to 0.23) | High |
| Epilepsy surgery | Continued antiepileptic drugs | Epilepsy | Proportion (%) free from seizures (1 year) | RR=9.78 (4.73 to 20.2)* | Low |
| Proportion free from all seizures including auras (1 year) | RR=15 (2.08 to 108.23) | Very low | |||
| Surgical decompression | Osmotic agents, blood pressure control and glucose control | Cerebral oedema in acute ischaemic stroke | Death at the end of follow-up | OR=0.19 (0.09 to 0.37) | |
| Surgical decompression | Dexamethasone, antihypertensives and intermittent diuresis | Primary supratentorial intracerebral haemorrhage | Death or dependence at end of follow-up | OR=0.71 (0.58 to 0.88) | |
| Suction aspiration | Misoprostol | Abortion | Complete miscarriage | RR=1.11 (1.06 to 1.17) | Very low |
| Complete miscarriage | RR=1.04 (1.02 to 1.06) | Very low | |||
| Dilatation and curettage | Misoprostol | Abortion | Complete miscarriage Combined major and minor complications |
RR=1.18 (1.1 to 1.27)* OR=0.12 (0.03 to 0.46) |
Very low |
| Dilatation and evacuation | Misoprostol | Abortion | |||
| Laparoscopic ovarian drilling | Medical ovulation induction | Infertility due to PCOS | Multiple pregnancy | OR=0.34 (0.18 to 0.66) | Moderate |
| Laparoscopic ovarian drilling | Gonadotropins | PCOS | Menstrual regularity at 6 months | OR=19.2 (3.17 to 116) | Very low |
| Transcervical resection of endometrium using rollerball coagulation | Hormone therapy or antifibrinolytic | Heavy menstrual bleeding | Control of bleeding (cure or improvement to acceptable level) 4 months. | RR=2.66 (1.94 to 3.64) | Moderate |
| Control of bleeding (cure or improvement to acceptable level) 2 years | RR=1.29 (1.06 to 1.57) | Low | |||
| Overall satisfaction with treatment 4 months. | RR=2.8 (1.96 to 3.99) | Moderate | |||
| Overall satisfaction with treatment 2 years | RR=1.4 (1.13 to 1.74) | Moderate | |||
| Adverse events at 4 months | RR=0.26 (0.15 to 0.46) | Moderate | |||
| Surgical correction | Botulinum toxin | Strabismus | Improved ocular alignment >10 dioptres, adults | RR=2.63 (1.18 to 5.9) | Low |
| iStent | Latanoprost/timolol | Open angle glaucoma | Proportion of participants who were drop‐free 6–18 months | RR=125 (17.8 to 884) | Very low |
| Argon laser trabeculoplasty | IOP reducing medication | Open angle glaucoma | Failure to control IOP | RR=0.8 (0.71 to 0.91) | |
| Arthroscopic surgery | Sclerosing injection | Jumper’s knee | Knee pain (0–100, 12 months) | MD=−28.3 (−41.79 to −14.81) | Low |
| Participant global assessment of success (1–100, 12 months) | MD=33.9 (18.74 to 49.06) | Low | |||
| Decompressive surgery with or without fusion | Epidural steroid injection | Lumbar spinal stenosis | Zurich claudication questionnaire (symptom evaluation) 6 weeks | MD=−0.6 (−0.77 to −0.43) | Low |
| Open unilateral sympathectomy (L2-4) | IV prostanoid iloprost | Complete ulcer healing w/o rest pain or major amputation (24 weeks) | RR=1.76 (1.35 to 2.29) | Low | |
| Grommets (ventilation tubes) | Antibiotic prophylaxis | Recurrent acute otitis media | Proportion of patients who have no recurrences (6 months) | RR=1.68 (1.07 to 2.65)* | Very Low |
| Tonsillectomy or adrenotonsillectomy | Watchful waiting with or without analgesics and antibiotics | Tonsillitis | Episodes of sore throat of any severity (children) | MD=−0.56 (−1.04 to −0.07)* | Moderate |
| Sore throat days (children) | MD=−5.13 (−8.03 to −2.2)* | Moderate | |||
| Episodes of sore throat of any severity (adults) | MD=3.61 (−7.92 to −0.7)* | Moderate | |||
| Sore throat days (adults) | MD=−10.64 (−15.52 to −5.76)* | Moderate | |||
| Aspirin and carotid surgery | Aspirin | Carotid stenosis | Any stroke or operative death | RR=0.85 (0.77 to 0.95)* | Moderate |
*Our reanalysis using a random effects meta-analysis model shows that the 95% CI includes the null (results are inconclusive).
BCC, basal cell carcinoma of the skin; GERD, gastro-oesophageal reflux disease; GNT, glyceryl trinitrate; GRADE, grading of recommendations, assessment, development, and evaluations; IOP, intraocular pressure; MD, mean difference; PCOS, polycystic ovarian syndrome; QOL, quality of life; RR, risk ratio; SMD, standardised mean difference.