Summary of findings for the main comparison.
Radioisotopes compared to Placebo for metastatic bone pain
| Radioisotopes compared to Placebo for metastatic bone pain | ||||||
| Patient or population: patients with metastatic bone pain Settings: Intervention: Radioisotopes Comparison: Placebo | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Placebo | Radioisotopes | |||||
| Pain relief ‐ Complete relief | Medium risk population1 | RR 2.1 (1.32 to 3.35) | 296 (4 studies) | ⊕⊕⊕⊝ moderate2,3 | 79 events | |
| 124 per 1000 | 260 per 1000 (164 to 415) | |||||
| Pain relief ‐ Complete/Partial relief | Medium risk population1 | RR 1.72 (1.13 to 2.63) | 119 (3 studies) | ⊕⊕⊕⊝ moderate3,4 | 49 events | |
| 182 per 1000 | 313 per 1000 (206 to 479) | |||||
| Compression of spinal cord | Medium risk population5 | RR 1.1 (0.39 to 3.07) | 270 (2 studies) | ⊕⊕⊝⊝ low3,6 | 16 events | |
| NA | NA | |||||
| Pain flares | Medium risk population5 | RR 0.74 (0.27 to 2.06) | 270 (2 studies) | ⊕⊕⊝⊝ low3,6 | 20 events | |
| NA | NA | |||||
| Thrombocytopenia III‐IV | Medium risk population1 | RR 2.21 (0.98 to 4.99) | 313 (4 studies) | ⊕⊕⊝⊝ low3,7 | 22 events | |
| 33 per 1000 | 73 per 1000 (32 to 165) | |||||
| Leucocytopenia III‐IV | High risk population8 | RR 5.9 (1.62 to 21.47) | 410 (4 studies) | ⊕⊕⊝⊝ low3,6 | 22 events | |
| 59 per 1000 | 348 per 1000 (96 to 1000) | |||||
| *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 Median baseline risk in the included studies 2 Two out of four studies had moderate risk of bias, while the other two had low risk of bias 3 Low number of events 4 Two out of three studies had low risk of bias 5 Not computed because the intervention has no significant effect 6 All studies with high risk of bias 7 Three out of four studies with high risk of bias 8Buchali 1988 baseline risk