TABLE 6.
GRADE rating of the quality of each outcome.
| Group | Outcomes | Anticipated absolute effects∗ (95% CI) | Relative effect (95% CI) | No of participants (studies) | Certainty of the evidence (GRADE) | |
|---|---|---|---|---|---|---|
| Risk with comparison | Risk with intervention | |||||
|
Intervention: CHM Alone Comparison: Blank Control |
Recurrence Rate | 333 per 1,000 | 111 per 1,000 (48–242) | OR 0.25 (0.1–0.64) | 126 (1 study) | ⊕⊕⊝⊝ low1,2 |
| Total Clinical Efficacy Rate | 825 per 1,000 | 952 per 1,000 (841–987) | OR 4.23 (1.12–15.99) | 126 (1 study) | ⊕⊕⊝⊝ low1,2 | |
| Visual Analog Scale Score | - | MD 0.86 lower (1.01–0.71 lower) | - | 126 (1 study) | ⊕⊕⊝⊝ low1,2 | |
| Pregnancy rate | 127 per 1,000 | 365 per 1,000 (189–586) | OR 3.95 (1.6–9.74) | 126 (1 study) | ⊕⊕⊝⊝ low1,2 | |
|
Intervention: CHM Alone Comparison: CWM |
Recurrence Rate | 232 per 1,000 | 73 per 1,000 (32–164) | OR 0.26 (0.11–0.65) | 190 (3 studies) | ⊕⊕⊝⊝ low1,2 |
| Total Clinical Efficacy Rate | 723 per 1,000 | 885 per 1,000 (778–944) | OR 2.94 (1.34–6.43) | 186 (3 studies) | ⊕⊕⊝⊝ low1,2 | |
| Visual Analog Scale Score | - | MD 0.16 lower (0.49 lower to 0.17 higher) | - | 60 (1 study) | ⊕⊕⊝⊝ low1,2 | |
| CA125 | - | MD 14.28 lower (17.09–11.47 lower) | - | 130 (2 studies) | ⊕⊝⊝⊝ very low1,2,3 | |
| Pregnancy rate | 373 per 1,000 | 663 per 1,000 (454–823) | OR 3.31 (1.4–7.83) | 116 (2 studies) | ⊕⊕⊝⊝ low1,2 | |
| Adverse event rate | 245 per 1,000 | 16 per 1,000 (3–75) | OR 0.05 (0.01–0.25) | 186 (3 studies) | ⊕⊕⊝⊝ low1,2 | |
| Recurrence Rate (6 months postoperatively) | 100 per 1,000 | 66 per 1,000 (11–316) | OR 0.64 (0.1–4.15) | 60 (1 study) | ⊕⊕⊝⊝ low1,2 | |
| Recurrence Rate (12 months postoperatively) | 292 per 1,000 | 76 per 1,000 (28–193) | OR 0.2 (0.07–0.58) | 130 (2 studies) | ⊕⊕⊝⊝ low1,2 | |
| Adverse event rate (Perimenopausal Symptoms) | 138 per 1,000 | 14 per 1,000 (3–74) | OR 0.09 (0.02–0.5) | 186 (3 studies) | ⊕⊕⊝⊝ low1,2 | |
| Adverse event rate (Androgenic Response) | 103 per 1,000 | 16 per 1,000 (1–243) | OR 0.14 (0.01–2.8) | 56 (1 study) | ⊕⊕⊝⊝ low1,2 | |
| Adverse event rate (Hepatic Function Impairment) | 119 per 1,000 | 15 per 1,000 (1–113) | OR 0.11 (0.01–0.94) | 116 (2 studies) | ⊕⊕⊝⊝ low1,2 | |
|
Intervention: CHM + CWM Comparison: CWM |
Recurrence Rate | 186 per 1,000 | 56 per 1,000 (37–84) | OR 0.26 (0.17–0.4) | 1,132 (13 studies) | ⊕⊕⊕⊝ moderate1 |
| Total Clinical Efficacy Rate | 803 per 1,000 | 933 per 1,000 (906–953) | OR 3.44 (2.37–5) | 1,228 (12 studies) | ⊕⊕⊕⊝ moderate1 | |
| Visual Analog Scale Score | - | MD 1.04 lower (1.08–0.99 lower) | - | 708 (8 studies) | ⊕⊕⊝⊝ low1,3 | |
| CA125 | - | MD 5.1 lower (5.8–4.4 lower) | - | 766 (9 studies) | ⊕⊕⊝⊝ low1,3 | |
| Pregnancy rate | 139 per 1,000 | 326 per 1,000 (171–530) | OR 2.99 (1.28–6.98) | 244 (3 studies) | ⊕⊕⊝⊝ low1,2 | |
| Adverse event rate | 233 per 1,000 | 101 per 1,000 (73–143) | OR 0.37 (0.26–0.55) | 954 (11 studies) | ⊕⊕⊕⊝moderate1 | |
| Recurrence Rate (3–6 months postoperatively) | 163 per 1,000 | 57 per 1,000 (36–94) | OR 0.31 (0.19–0.53) | 722 (8 studies) | ⊕⊕⊕⊝moderate1 | |
| Recurrence Rate (7–12 months postoperatively) | 170 per 1,000 | 47 per 1,000 (16–132) | OR 0.24 (0.08–0.74) | 176 (2 studies) | ⊕⊕⊝⊝ low1,2 | |
| Recurrence Rate (13–24 months postoperatively) | 353 per 1,000 | 57 per 1,000 (11–234) | OR 0.11 (0.02–0.56) | 68 (1 study) | ⊕⊕⊝⊝ low1,2 | |
| Recurrence Rate (25–36 months postoperatively) | 229 per 1,000 | 61 per 1,000 (23–153) | OR 0.22 (0.08–0.61) | 166 (2 studies) | ⊕⊕⊝⊝ low1,2 | |
| VAS Score (3-month treatment) | - | MD 0.7 lower (0.79–0.61 lower) | - | 426 (5 studies) | ⊕⊕⊕⊝moderate1 | |
| VAS Score (6-month treatment) | - | MD 1.13 lower (1.18–1.08 lower) | - | 282 (3 studies) | ⊕⊕⊝⊝ low1,2 | |
| CA125 (CHM + Goserelin VS Goserelin) | - | MD 8.93 lower (11.66–6.19 lower) | - | 166 (2 studies) | ⊕⊕⊝⊝ low1,2 | |
| CA125 (CHM + Triptorelin VS Triptorelin) | - | MD 4.78 lower (5.79–3.77 lower) | - | 326 (3 studies) | ⊕⊕⊝⊝ low1,2 | |
| CA125 (CHM + Gestrinone VS Gestrinone) | - | MD 8.86 lower (10.85–6.87 lower) | - | 86 (1 study) | ⊕⊕⊝⊝ low1,2 | |
| CA125 (CHM + Mifepristone VS Mifepristone) | - | MD 1.93 lower (3.34–0.53 lower) | - | 128 (2 studies) | ⊕⊕⊝⊝ low1,2 | |
| CA125 (CHM + Leuprorelin VS Leuprorelin) | - | MD 1.17 lower (7.05–4.71 lower) | - | 60 (1 study) | ⊕⊕⊝⊝ low1,2 | |
| Adverse event rate (Perimenopausal Symptoms) | 174 per 1,000 | 70 per 1,000 (42–114) | OR 0.36 (0.21–0.61) | 632 (8 studies) | ⊕⊕⊕⊝moderate1 | |
| Adverse event rate (Androgenic Response) | 58 per 1,000 | 34 per 1,000 (12–92) | OR 0.58 (0.20–1.65) | 346 (3 studies) | ⊕⊕⊕⊝moderate1 | |
| Adverse event rate (Hepatic Function Impairment) | 117 per 1,000 | 49 per 1,000 (22–109) | OR 0.39 (0.17–0.92) | 308 (4 studies) | ⊕⊕⊕⊝moderate1 | |
| Adverse event rate (Gastrointestinal Discomfort) | 67 per 1,000 | 51 per 1,000 (25–102) | OR 0.75 (0.36–1.58) | 504 (5 studies) | ⊕⊕⊕⊝moderate1 | |
| Adverse event rate (Physical Pain) | 36 per 1,000 | 23 per 1,000 (6–84) | OR 0.63 (0.16–2.45) | 278 (3 studies) | ⊕⊕⊝⊝ low1,2 | |
| Adverse event rate (Allergic Reactions) | 57 per 1,000 | 22 per 1,000 (5–90) | OR 0.37 (0.08–1.63) | 210 (2 studies) | ⊕⊕⊝⊝ low1,2 | |
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparator group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; MD: Mean difference; OR: Odds ratio. Factors of downgrade: 1 Unclear risk of detection bias, selection bias and performance bias; 2 Sample size is less than the optimal information size; 3 Significant statistical heterogeneity. GRADE Working Group grades of evidence: High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: 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 quality: We are very uncertain about the estimate.