Table 4:
Evidence profile and pooled effect estimates to inform PICO questions 2–4
| Outcome | Estimate (95% CI) | Certainty of Evidence | Risk of Bias | Inconsistency | Imprecision | Indirectness | |
|---|---|---|---|---|---|---|---|
| Incidence rate of any dysplasia in patients with GIM | 97.6/10,000 p-y (77.3 – 120.0) | ⊕⊕○○ Low |
Not serious | Serious | Not serious | Serious | |
| Cumulative incidence of any dysplasia in patients with GIM | at 3 years | 15.0% (13.2 – 16.8) | ⊕○○○ Very low |
Serious | Serious | Not serious | Serious |
| at 5 years | 15.0% (13.2 – 17.0) | ⊕⊕○○ Low |
Not serious | Serious | Not serious | Serious | |
| Cumulative incidence of HGD or gastric cancer in patients with GIM at 5 years | 2.7% (1.8 – 3.8) | ⊕○○○ Very low |
Not serious | Not serious | Very serious | Serious | |
| Incidence rate of gastric cancer in patients with GIM | all geographies | 12.4/10,000 p-y (10.7 – 14.3) | ⊕⊕○○ Low |
Serious1 | Serious1 | Not serious | Serious |
| US geography only | 8.2/10,000 p-y (5.1 – 12.0) | ⊕⊕○○ Low |
Serious | Not serious | Serious | Not serious | |
| Cumulative incidence of gastric cancer in patients with GIM | within 1 year | 0.5% (0.4 – 0.6) | ⊕⊕○○ Low |
Serious | Not serious | Not serious | Serious |
| at 3 years | 0.4% (0.1 – 0.8) | ⊕○○○ Very low |
Not serious | Not serious | Very serious | Serious | |
| at 5 years | 1.1% (1.0 – 1.2) | ⊕⊕○○ Low |
Serious | Not serious | Not serious | Serious | |
| at 10 years | 1.6% (1.5 – 1.7) | ⊕○○○ Very low |
Serious | Serious | Not serious | Serious | |
| Cumulative incidence of gastric cancer in patients with GIM based on race/ethnicity | Asian | 0.3% (0.1 – 0.8) | ⊕○○○ Very low |
Serious | Not serious | Very serious | Not serious |
| Black | 0.4% (0.0 – 1.4) | ⊕○○○ Very low |
Serious | Not serious | Very serious | Not serious | |
| Hispanic | 1.0% (0.4 – 1.7) | ⊕○○○ Very low |
Serious | Not serious | Very serious | Not serious | |
| White | 0.3% (0.1 – 0.6) | ⊕○○○ Very low |
Serious | Not serious | Very serious | Not serious | |
| Other | 0.1% (0.0 – 0.9) | ⊕○○○ Very low |
Serious | Not serious | Very serious | Not serious | |
| Relative risk of incident gastric cancer in patients with GIM and first degree family history of gastric cancer vs. no first degree family history | 4.5 (1.3 – 15.5) | ⊕○○○ Very low |
Serious | Not serious | Very serious | Not serious | |
| Relative risk of incident gastric cancer in patients with incomplete vs. complete GIM on histology | 3.3 (2.0 – 5.6) | ⊕⊕○○ Low |
Not serious | Not serious | Serious | Serious | |
| Relative risk of incident gastric dysplasia in patients with incomplete vs. complete GIM on histology | 1.7 (0.8 – 3.7) | ⊕⊕○○ Low |
Not serious | Not serious | Serious2 | Serious | |
| Relative risk of incident gastric cancer in patients with extensive vs. limited GIM | 2.1 (1.0 – 4.4) | ⊕○○○ Very low |
Serious | Not serious | Very serious | Not serious | |
| Relative risk of incident gastric cancer in patients with GIM who smoke(d) tobacco vs. none smokers | 1.0 (0.3 – 4.1) | ⊕○○○ Very low |
Serious | Not serious | Very serious | Not serious | |
| Cumulative risk of GIM regression to improved global histology | at 1 year | 29.7% (24.5 – 35.2) | ⊕○○○ Very low |
Serious | Not serious | Serious | Serious |
| at 3 years | 19.4% (17.4 – 21.4) | ⊕○○○ Very low |
Serious | Serious | Not serious | Serious | |
| at 5 years | 25.9% (23.7 – 28.2) | ⊕○○○ Very low |
Serious | Serious | Not serious | Serious | |
1
we rated down one level only for both risk of bias (few studies lacked protocolized biopsies) and inconsistency (most of the evidence was consistent except two small studies) together.
2
despite the narrow confidence interval, we elected to rate down for imprecision due to the small number of events.
Abbreviations: GIM, gastric intestinal metaplasia; HGD, high grade dysplasia.