Table 1.
Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Summary of Findings table for primary outcomes.
| The Effects of Various Phlebotomy Techniques for Animals Welfare-Related Outcomes | |||
|---|---|---|---|
| Patient or Population: Laboratory Mice Used for Research Purposes Interventions of Interest: Sublingual Sampling, Retrobulbar Sampling, Facial Vein Sampling, Tail Amputation Sampling, Tail Incision Sampling, Tail Vein Sampling and Saphenous Vein Sampling | |||
| Outcomes | Impact | Number of Participants (Studies) | Certainty of the Evidenc (GRADE) |
| Plasma Glucose Concentration | |||
| Single Sampling | The facial vein technique was involved in the most pairwise comparisons synthesised, and was found to have a beneficial effect when compared to the tail amputation and the tail incision techniques. The tail incision technique was likewise considered to be beneficial compared to the tail amputation method. The retrobulbar technique was considered beneficial to the tail vein technique, and the sublingual technique beneficial to the facial vein technique. | (3 RCTs) | ⨁◯◯◯ VERY LOW a,b,c |
| Serial Sampling | The retrobulbar technique was involved in 4 pairwise comparisons and was considered harmful compared to the tail amputation and the tail incision methods. Yet it was beneficial when compared to the facial vein method. Tail amputation was similarly beneficial over the tail incision technique, and the saphenous technique was beneficial compared to the tail vein technique. | (3 RCTs) | ⨁◯◯◯ VERY LOW a,c,d |
| Plasma Corticosterone Concentration | |||
| Single Sampling | The retrobulbar technique proved to be more beneficial compared to the facial vein technique in two studies, beneficial to the tail vein and saphenous methods in one study each, yet harmful when compared to the tail incision technique based on the results from one study. Neither a harmful or beneficial effect was observed comparing the facial vein and the tail vein method; the tail amputation and the saphenous technique; or the tail vein and the tail incision method. | (5 RCTs) | ⨁◯◯◯ VERY LOW a,e,f |
| Serial Sampling | The tail amputation technique was considered beneficial in two pairwise comparisons against the retrobulbar technique, and beneficial in a pairwise comparison against the facial vein technique. However, no difference was observed when compared with the saphenous vein technique. Likewise, the saphenous vein technique was considered beneficial when compared against both the retrobulbar and the facial vein technique. | (3 RCTs) | ⨁◯◯◯ VERY LOW a,e,g |
| Faecal Corticosterone | |||
| Serial Sampling | There appears to be a time-dependent factor for the pairwise comparison of the retrobulbar technique and the tail incision technique. While the tail vein was shown to be beneficial compared to the facial vein. | (4 RCTs) | ⨁◯◯◯ VERY LOW a,h,i |
| Body Weight | |||
| Single Sampling | The saphenous vein technique was considered ‘beneficial’ in pairwise comparisons with the sublingual, retrobulbar, facial, tail amputation and tail incision methods. This technique was not considered ‘harmful’ in any pairwise comparison synthesised. The next most beneficial technique synthesised was the sublingual technique, which was considered beneficial in two separate comparisons made to the facial vein technique, and single comparisons made to the retrobulbar; tail amputation and tail incision techniques. The tail amputation technique was beneficial over the retrobulbar; facial vein and the tail incision methods. The retrobulbar and facial vein methods were associated with the most harm, as compared through pairwise comparison. | (5 RCTs) | ⨁◯◯◯ VERY LOW a,j |
| Serial Sampling | The retrobulbar technique was considered beneficial in two separate pairwise comparisons made to the facial vein technique, as well as being beneficial when compared to the sublingual technique. | (3 RCTs) | ⨁◯◯◯ VERY LOW k,l |
|
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. | |||
a Downgraded two levels for risk of bias as there is a high risk of performance bias across all contributing studies. b Downgraded two levels for inconsistency. The direction and magnitude of pairwise comparisons varied across the different studies. In addition, one comparison involved animals that were anaesthetised c Downgraded one level for imprecision—only 3 studies of limited size contributed data towards this outcome and no two studies included the same pairwise comparison, disallowing a synthesised pairwise comparison to be obtained. d Downgraded two levels for inconsistency. The direction and magnitude of pairwise comparisons varied across the different studies. e Downgraded one level for inconsistency. Of the one pairwise comparison that was presented in two separate studies, the same direction of effect was observed. However, multiple other comparisons included in the outcome were regarded as having no difference. f Downgraded one level for imprecision. Five adequately powered studies have contributed towards this outcome synthesis and there are multiple studies that provide data towards the same pairwise comparison. However due to the nature of synthesis we have borderline concerns with imprecision. g Downgraded one level for imprecision—only 3 studies of limited size contributed data towards this outcome and only one pairwise comparison was included across multiple studies h Downgraded two levels for inconsistency. Few different pairwise comparisons were made across studies, of the one comparison that was synthesised across multiple studies the result differs substantially i Downgraded one level for imprecision—only 3 small studies have contributed data towards this outcome synthesis j There are multiple pairwise comparisons made for this outcome and the direction of effect appears to be consistent. However, the review team believed that the domains of both inconsistency and imprecision were borderline calls and have downgraded one level between the two k Downgraded one level for inconsistency. Only one pairwise comparison was observed over multiple studies. However, the direction of that comparison occurred in the same direction across studies. Wide variation in results from other pairwise comparisons across results from included studies l Downgraded one level for imprecision—only 3 studies of limited size contributed data towards this outcome. Primary outcome data considered using GRADE are bolded.