Summary of findings 2. Self‐monitoring of oral anticoagulation vs. standard care.
| Self‐monitoring of oral anticoagulation vs. standard care | |||||
|
Patient or population: Patients on long‐term anticoagulant therapy (treatment duration longer than two months) irrespective of the indication for treatment Settings: Primary care, specialist clinics (Europe, America, Canada) Intervention: Self‐monitoring Comparison: Standard care | |||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | |
| Assumed risk | Corresponding risk | ||||
| Standard care | Self‐monitoring | ||||
|
Thromboembolic events Follow‐up: 3 to 57 months |
Study population | RR 0.69 (0.49 to 0.97) | 4097 (7 studies) | ⊕⊕⊕⊝ Moderate2 | |
| 35 per 1000 | 24 per 1000 (17 to 34) | ||||
| Moderate risk population | |||||
| 34 per 1000 | 23 per 1000 (17 to 33) | ||||
|
All‐cause mortality Follow‐up: 6 to 57 months |
Study population | RR 0.94 (0.78 to 1.15) | 3300 (3 studies) | ⊕⊕⊕⊝ Moderate2 | |
| 90 per 1000 | 85 per 1000 (70 to 104) | ||||
| Moderate risk population | |||||
| 0 per 1000 | 0 per 1000 (0 to 0) | ||||
|
Major haemorrhage Follow‐up: 4 to 57 months |
Study population | RR 0.90 (0.74 to 1.09) | 4038 (7 studies) | ⊕⊕⊝⊝ Low1 | |
| 91 per 1000 | 82 per 1000 (67 to 99) | ||||
| Moderate risk population | |||||
| 49 per 1000 | 44 per 1000 (36 to 53) | ||||
|
Minor haemorrhage Follow‐up: 4 to 57 months |
Study population | RR 1.16 (0.95 to 1.42) | 3503 (6 studies) | ⊕⊕⊕⊝ Moderate2 | |
| 275 per 1000 | 319 per 1000 (259 to 391) | ||||
| Moderate risk population | |||||
| 188 per 1000 | 218 per 1000 (177 to 267) | ||||
| *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% 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; RR: Risk Ratio | |||||
| GRADE Working Group grades of evidence High quality: We are very confident that the true effect lies close to that of the estimate of the effect. Moderate quality: 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 quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect. Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect. | |||||
1 Downgraded from high to low because of serious risk of bias and strong suspicion of publication bias.
2 Downgraded from high to moderate because of serious risk of bias.