Summary of findings for the main comparison. Pre‐hospital versus in‐hospital thrombolysis for ST‐elevation myocardial infarction.
| Pre‐hospital versus in‐hospital thrombolysis for ST‐elevation myocardial infarction | ||||||
| Participants or population: participants with ST‐elevation myocardial infarction Settings: USA, France and Germany Intervention: Pre‐hospital versus in‐hospital thrombolysis | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No. of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Control | Pre‐hospital versus in‐hospital thrombolysis | |||||
| All‐cause hospital mortality Follow up: 30 days1 | 73 per 1000 | 53 per 1000 (27 to 103) | RR 0.73 (0.37 to 1.41) | 538 (3 studies) | ⊕⊕⊝⊝ low2,3 | |
| *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% 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 | ||||||
| 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 Follow up ranged from 15 days to 1 month 2 Downgraded by 1 level for risk of bias due to poor reporting of random sequence generation, allocation concealment (not described and concealment broken) and inadequate outcome reporting in Castaigne 1989 3 Downgraded by 1 level for imprecision as CI includes appreciable benefit and appreciable harm.