Summary of findings for the main comparison. Oestrogen ring compared to other regimens for vaginal atrophy in postmenopausal women.
| Oestrogen ring compared to other regimens for vaginal atrophy in postmenopausal women | ||||||
| Patient or population: postmenopausal women with vaginal atrophy Settings: outpatient clinic Intervention: oestrogen ring Comparison: other regimen | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Other regimen | Oestrogen ring | |||||
| Improvement in symptoms (participant‐assessed) (oestrogen ring vs oestrogen cream) | 717 per 1000 | 771 per 1000 (670 to 847) | OR 1.33 (0.80 to 2.19) | 341 ( 2studies) | ⊕⊕⊝⊝ low1,2 | |
| Improvement in symptoms (participant‐assessed) (oestrogen ring vs oestrogen tablets) | 582 per 1000 | 521 per 1000 (425 to 616) | OR 0.78 (0.53 to 1.15) | 567 (3 studies) | ⊕⊕⊝⊝ low1,2 | |
| Endometrial thickness (oestrogen ring vs oestrogen cream) | 117 per 1000 | 46 per 1000 (18 to 111) | OR 0.36 (0.14 to 0.94) | 273 (2 studies) | ⊕⊕⊝⊝ low1,3 | |
| Improvement in symptoms (clinician‐assessed) (oestrogen ring vs oestrogen cream) | 706 per 1000 | 714 per 1000 (627 to 786) | OR 1.04 (0.70 to 1.53) | 533 (3 studies) | ⊕⊕⊝⊝ low1,2 | |
| Improvement in symptoms (clinician‐assessed) (oestrogen ring vs oestrogen tablets) | 636 per 1000 | 717 per 1000 (611 to 802) | OR 1.45 (0.90 to 2.32) | 397 (2 studies) | ⊕⊕⊝⊝ low1,2 | |
| Adverse events (total adverse events) (oestrogen ring vs oestrogen cream) | 364 per 1000 | 335 per 1000 (212 to 483) | OR 0.88 (0.47 to 1.63) | 192 (1 study) | ⊕⊕⊝⊝ low2,3 | |
| Adverse events (total adverse events) (oestrogen ring vs placebo) | 444 per 1000 | 264 per 1000 (81 to 587) | OR 0.45 (0.11 to 1.78) | 37 (1 study) | ⊕⊕⊕⊝ moderate3 | |
| *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. | ||||||
1 Downgraded by 1 level as most risk of bias domains were rated either as unclear or high 2 Downgraded by 1 level due to effect estimate with wide confidence interval 3 Downgraded by 1 level due to small sample size