Table 3:

Change in Depression Scores for rTMS Versus ECT

Author, Year	No. of Studies (Sample Size)	Results	Quality of Primary Studies	Conclusions
Lepping et al, 201442	5 (212)	“In those rTMS studies that used ECT as a comparator, ECT was more effective than rTMS which only reached a HDRS percentage reduction of 33.7%”	NR	No specific conclusions on this comparator
Health Quality Ontario, 201618	4 (185)	WMD −5.97 (95% CI −11.0 to −0.94, P = .020) I2 = 72.2% Favouring ECT SMD −0.67 (95% CI −1.23 to −0.10, P = .021) I2 = 70.6% Favouring ECT	Moderate to high ROBa	“Trials of high-frequency rTMS of the DLPFC vs. ECT showed significantly more improvement in depression scores with ECT treatment than with rTMS treatment”

Abbreviations: CI, confidence interval; DLPFC, dorsolateral prefrontal cortex; ECT, electroconvulsive therapy; HDRS, Hamilton Depression Rating Scale; NR, not reported; ROB, risk of bias; rTMS, repetitive transcranial magnetic stimulation; SMD, standardized mean difference; WMD, weighted mean difference.

^aOne study (Eranti et al¹²⁸) had low ROB, while 2 studies had moderate ROB (Grunhaus et al,^129,130 Pridmore et al,¹³¹) and two had high ROB (Grunhaus et al,^129,130 Keshtkar et al¹³²).