Table 3.

Summary of findings for topical diclofenac compared with placebo in patients with osteoarthritis

Outcomes	No. of participants (studies)	Certainty of the evidence (GRADE)	Relative effect (95% CI)	Anticipated absolute effects
				Risk with placebo	Risk difference with topical diclofenac
Skin and subcutaneous tissue disorders	2705 (8 RCTs)	⨁⨁⨁⨁ HIGH	OR 1.73 (0.96–3.10)	21 per 1000	15 more per 1000 (1 fewer to 41 more)
Gastrointestinal disorders	2705 (8 RCTs)	⨁⨁⨁⨁ HIGH	OR 1.11 (0.75–1.64)	38 per 1000	4 more per 1000 (9 fewer to 23 more)
Cardiac disorders	2705 (8 RCTs)	⨁⨁⨁◯ MODERATEa	OR 1.59 (0.26–9.73)	2 per 1000	1 more per 1000 (2 fewer to 19 more)
Vascular disorders	2705 (8 RCTs)	⨁⨁⨁⨁ HIGH	OR 1.19 (0.53–2.66)	11 per 1000	2 more per 1000 (5 fewer to 18 more)
Nervous system disorders	2705 (8 RCTs)	⨁⨁⨁⨁ HIGH	OR 1.01 (0.80–1.28)	122 per 1000	1 more per 1000 (22 fewer to 29 more)
Serious adverse events	1279 (5 RCTs)	⨁⨁⨁⨁ HIGH	OR 0.94 (0.26–3.42)	8 per 1000	0 fewer per 1000 (6 fewer to 19 more)

The risk in the intervention group (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI)

GRADE Working Group grades of evidence: High certainty we are very confident that the true effect lies close to that of the estimate of the effect; Moderate certainty we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different; Low certainty our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect; Very low certainty we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect

CI confidence interval, GRADE Grading of Recommendations Assessment, Development and Evaluation, OR odds ratio, RCTs randomized controlled trials

^aWide CI because of the few numbers of events