Summary of findings for the main comparison. Medial epicondylectomy plus oral steroids versus oral steroids alone for treating nerve damage in leprosy.
| Medial epicondylectomy plus oral steroids versus oral steroids alone for treating nerve damage in leprosy | ||||||
| Patient or population: patients with nerve damage in leprosy Settings: hospital Intervention: medial epicondylectomy plus oral steroids versus oral steroids alone | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Control | medial epicondylectomy plus oral steroids versus oral steroids alone | |||||
| Change in sensory score after one year | The mean change in sensory score after one year ranged across control groups from 0.06‐3.94 points | The mean change in sensory score after one year in the intervention groups was 0.08 higher (2.45 lower to 2.61 higher) | 57 (1 study) | ⊕⊝⊝⊝ very low1,2,3 | ||
| Proportion of ulnar nerves with sensory improvement after one year | 516 per 1000 | 578 per 1000 (366 to 913) | RR 1.12 (0.71 to 1.77) | 62 (1 study) | ⊕⊝⊝⊝ very low1,2,3 | |
| Change in motor score after one year | The mean change in motor score after one year ranged across control groups from 0.21‐4.31 points | The mean change in motor score after one year in the intervention groups was 0.82 higher (1.34 lower to 2.98 higher) | 57 (1 study) | ⊕⊝⊝⊝ very low1,2,3 | ||
| Proportion of ulnar nerves with motor improvement after one year | 710 per 1000 | 646 per 1000 (454 to 909) | RR 0.91 (0.64 to 1.28) | 62 (1 study) | ⊕⊝⊝⊝ very low1,2,3 | |
| Change in sensory score after two years | The mean change in sensory score after two years ranged across control groups from 0.73‐5.09 points | The mean change in sensory score after two years in the intervention groups was 0.02 lower (2.82 lower to 2.78 higher) | 57 (1 study) | ⊕⊝⊝⊝ very low1,2,3 | ||
| Change in motor score after two years | The mean change in motor score after two years ranged across control groups from 0.49‐4.65 points | The mean change in motor score after two years in the intervention groups was 0.22 higher (2.39 lower to 2.83 higher) | 57 (1 study) | ⊕⊝⊝⊝ very low1,2,3 | ||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RR: risk ratio | ||||||
| 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. | ||||||
1 Randomisation by alternation. Blinding of patients and clinicians not possible; blinding of outcome assessor not reported. 17% loss to follow‐up of nerves; no intention to treat analysis was performed. 2 Data from only one trial available. 3 No separate analysis was done using only one independent outcome from each patient (results from a patient contributing outcomes from more than one nerve will be treated, in the analysis, as having more weight as a patient contributing only one nerve).