Summary of findings for the main comparison. Routine preoperative medical testing compared with selective or no testing for cataract surgery.
| Routine preoperative medical testing compared with selective or no testing for cataract surgery | |||||
|
Population: adults with age‐related cataract Settings: hospital or clinic Intervention: routine preoperative medical testing Comparison: selective or no preoperative medical testing | |||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No. of participants (studies) | Certainty of the evidence (GRADE) | |
| Assumed risk | Corresponding risk | ||||
| Selective or no testing | Preoperative medical testing | ||||
|
Medical adverse events up to 2 months after surgery |
33 per 1000 | 33 per 1000 (28 to 38) | OR 1.00 (0.86 to 1.16) | 21,531 (3 studies) | ⊕⊕⊕⊕ high |
| Ocular adverse events up to 2 months after surgery | Intraoperative | OR 0.99 (0.71 to 1.38) | 2281 (2 studies) | ⊕⊕⊕⊝ moderate1 | |
| 69 per 1000 | 68 per 1000 (49 to 96) | ||||
| Postoperative | OR 1.11 (0.74 to 1.67) | ||||
| 43 per 1000 | 48 per 1000 (32 to 72) | ||||
|
Cost for preoperative testing prior to surgery |
BRL 4.32 per patient | BRL 11.00 per patient | Ratio 2.55 | 1005 (1 study) | ⊕⊕⊕⊝ moderate2 |
|
Cancellation of cataract surgery prior to surgery |
16 per 1000 | 16 per 1000 (13 to 20) | OR 0.97 (0.78 to 1.21) | 20,582 (2 studies) | ⊕⊕⊕⊕ high |
|
Clinical management changes (other than cancellation) prior to surgery |
Not reported by any included study | ||||
|
Quality of life outcomes at any follow‐up time point |
Not reported by any included study | ||||
| *The basis for the assumed risk is the comparison group risk across studies. The corresponding risk (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention group (and its 95% CI). CI: confidence interval; OR: odds 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. | |||||
1Downgraded for imprecision of the estimate (i.e. wide confidence intervals). 2Downgraded for reporting bias due to lack of information regarding the confidence interval around the effect estimate.