Table 2.
Analysis and quality of the evidence using GRADE for efficacy and safety outcomes
| Outcomes | No of participants (studies) | Relative effect (95% CI) | Risk of bias | Inconsistency | Indirectness | Imprecision | Publication bias | Quality of the evidence (GRADE) |
|---|---|---|---|---|---|---|---|---|
| 1. Subgroup Analysis - Cilostazol compared to Aspirin for the Secondary Prevention of Stroke in the Chronic phase | ||||||||
| ROCI | 3459 (3 studies) | RR 0.82 (0.62 to 1.08) | No serious | No serious | No serious | No serious | Undetected | ⊕ ⊕ ⊕ ⊕ high |
| HSSH | 3459 (3 studies) | RR 0.29 (0.15 to 0.56)*** | No serious | No serious | No serious | No serious | Undetected | ⊕ ⊕ ⊕ ⊕ high |
| ACD | 3459 (3 studies) | RR 0.80 (0.42 to 1.53) | No serious | No serious | No serious | No serious | Undetected | ⊕ ⊕ ⊕ ⊕ high |
| 2. Sensitivity Analysis - Cilostazol compared to Aspirin for the Secondary Prevention of Stroke in the Chronic phase without CSPS 2 trial | ||||||||
| ROCI | 787 (2 studies) | RR 0.81 (0.40 to 1.66) | Serious1 | No serious | No serious | No serious | Undetected | ⊕ ⊕ ⊕⊝ moderate |
| HSSH | 787 (2 studies) | RR 0.18 (0.03 to 0.99)* | Serious1 | No serious | No serious | No serious | Undetected | ⊕ ⊕ ⊕⊝ moderate |
| ACD | 787 (2 studies) | RR 0.47 (0.13 to 1.64) | Serious1 | No serious | No serious | No serious | Undetected | ⊕ ⊕ ⊕⊝ moderate |
| 3. Sensitivity Analysis - Cilostazol compared to Aspirin for the Secondary Prevention of Stroke in the Chronic phase without Guo-2009 trail | ||||||||
| ROCI | 3391 (2 studies) | RR 0.80 (0.61 to 1.07) | No serious | No serious | No serious | No serious | Undetected | ⊕ ⊕ ⊕ ⊕ high |
| HSSH | 3391 (2 studies) | RR 0.29 (0.15 to 0.56)*** | No serious | No serious | No serious | No serious | Undetected | ⊕ ⊕ ⊕ ⊕ high |
| ACD | 3391 (2 studies) | RR 0.89 (0.45 to 1.73) | No serious | No serious | No serious | No serious | Undetected | ⊕ ⊕ ⊕ ⊕ high |
ROCI: Recurrence of Cerebral Infarction; HSSH: Hemorrhage Stroke or Subarachnoid Hemorrhage; ACD: All Case Death; CI: Confidence Interval; RR: Risk Ratio; *P < 0.05; ***P < 0.001.
1Potential bias because of unclear of blinding.
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.