Summary of findings 3. Tibolone compared with combined HT for treatment of vasomotor symptoms in postmenopausal women.

Tibolone compared with combined HT for postmenopausal women: vasomotor symptoms
Population: postmenopausal women with vasomotor symptoms Settings: outpatient or community Intervention: tibolone Comparison: combined HT
Outcomes	Illustrative comparative risks* (95% CI)		Relative effect (95% CI)	Number of participants (studies)	Quality of the evidence (GRADE)	Comments
	Assumed risk	Corresponding risk
	Combined HT	Tibolone
Vasomotor symptoms (tibolone 2.5 mg/d) Follow‐up: 3 to 12 months	70 per 1000	110 per 1000 (80 to 140)	OR 1.57 (1.18 to 2.1)	646 (4 studies)	⊕⊝⊝⊝ moderatea	From a sensitivity analysis excluding studies with high risk of attrition bias. An inclusive analysis (9 studies, 1336 participants) suggests a similar but slightly reduced disadvantage of tibolone (OR (95% CI) 1.36 (1.11 to 1.66))
*The basis for the assumed risk is the median control group risk across studies. 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; 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

^aDowngraded one level for serious risk of bias: poor reporting of study methods and potential conflict of interest in all studies. Effect estimate robust to a sensitivity analysis excluding studies at high risk of attrition bias