Summary of findings for the main comparison. Interventions compared to conservative management for brain arteriovenous malformations in adults.
| Interventions compared to conservative management for brain arteriovenous malformations in adults | ||||||
|
Patient or population: adults with a brain arteriovenous malformation
Setting: secondary care
Intervention: interventions (neurosurgery, embolization, or stereotactic radiosurgery, alone or in combination) Comparison: conservative management | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with conservative management | Risk with intervention | |||||
| Death or dependence | Study population | RR 2.53 (1.28 to 4.98) | 213 (1 RCT) | ⊕⊕⊕⊝ Moderate | High risk of performance bias due to participants and treating physicians not being blinded | |
| 95 per 1000 | 241 per 1000 (122 to 474) | |||||
| Symptomatic intracerebral haemorrhage | Study population | RR 6.75 (2.07 to 21.96) | 218 (1 RCT) | ⊕⊕⊕⊕ Moderate | High risk of performance bias due to participants and treating physicians not being blinded | |
| 28 per 1000 | 189 per 1000 (58 to 616) | |||||
| Epileptic seizure | Study population | RR 1.14 (0.63 to 2.06) | 217 (1 RCT) | ⊕⊕⊝⊝ Moderate | High risk of performance bias due to participants and treating physicians not being blinded | |
| 159 per 1000 | 181 per 1000 (100 to 327) | |||||
| Symptomatic radiation necrosis ‒ not reported | ‐ | ‐ | ‐ | ‐ | ‐ | |
| Quality of life ‒ not reported | ‐ | ‐ | ‐ | ‐ | ‐ | |
| *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). CI: Confidence interval; RR: Risk ratio; OR: Odds ratio | ||||||
| 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 | ||||||