Table 3.
GRADE evidence profile for PICO 1.
| Certainty assessment | № of patients | Effect | Certainty | Importance | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| № of studies | Study design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | MT alone | IVT + MT | Relative (95% CI) | Absolute (95% CI) | ||
| Good outcome (mRS 0-2 at 90 days) - OR, unadjusted analysis | ||||||||||||
| 6 | randomised trials6-9,11,12 | not serious | serious a | not serious | not serious | none | 570/1162 (49.1%) | 595/1169 (50.9%) | OR 0.93 (0.79 to 1.10) | 18 fewer per 1 000 (from 59 fewer to 24 more) | ⊕⊕⊕○ Moderate | CRITICAL |
| Good outcome (mRS 0–2 at 90 days) - RR, unadjusted analysis | ||||||||||||
| 6 | randomised trials | not serious | serious a | not serious | not serious | none | 570/1162 (49.1%) | 595/1169 (50.9%) | RR 0.96 (0.89 to 1.04) | 20 fewer per 1 000 (from 56 fewer to 20 more) | ⊕⊕⊕○ Moderate | CRITICAL |
| Reduced disability (≥1-point reduction across all mRS-scores at 90 days) - common OR, adjusted analysis | ||||||||||||
| 6 | randomised trials | not serious | serious a | not serious | not serious | none | cOR 0.92 (0.80 to 1.07) | 1 fewer per 1 000 (from 1 fewer to 1 fewer) | ⊕⊕⊕○ Moderate | CRITICAL | ||
| Excellent outcome (mRS 0–1 at 90 days) - OR, unadjusted analysis | ||||||||||||
| 6 | randomised trials | not serious | seriousa | not serious | not serious | none | 358/1169 (30.6%) | OR 0.99 (0.82 to 1.18) | 2 fewer per 1 000 (from 40 fewer to 36 more) | ⊕⊕⊕○ Moderate | CRITICAL | |
| All-cause mortality at 90 days - OR, unadjusted analysis | ||||||||||||
| 6 | randomised trials | not serious | not serious | not serious | not serious | none | 186/1163 (16.0%) | 175/1169 (15.0%) | OR 1.06 (0.84 to 1.35) | 8 more per 1 000 (from 21 fewer to 42 more) | ⊕⊕⊕⊕ High | CRITICAL |
| Successful reperfusion (mTICI ≥2b) at the end of the endovascular procedure | ||||||||||||
| 6 | randomised trials | not serious | not serious | not serious | not serious | None | 935/1108 (84.4%) | 990/1125 (88.0%) | OR 0.72 (0.57 to 0.92) | 39 fewer per 1 000 (from 73 fewer to 9 fewer) | ⊕⊕⊕⊕ High | IMPORTANT |
| Symptomatic intracranial haemorrhage | ||||||||||||
| 6 | randomised trials | not serious | serious b | not serious | not serious | None | 50/1163 (4.3%) | 67/1166 (5.7%) | OR 0.77 (0.52 to 1.13) | 13 fewer per 1 000 (from 27 fewer to 7 more) | ⊕⊕⊕○ Moderate | CRITICAL |
| Any intracranial haemorrhage | ||||||||||||
| 6 | randomised trials | not serious | not serious | not serious | not serious | None | 361/1138 (31.7%) | 415/1140 (36.4%) | OR 0.80 (0.66 to 0.96) | 50 fewer per 1 000 (from 90 fewer to 9 fewer) | ⊕⊕⊕⊕ High | IMPORTANT |
CI: confidence interval; OR: odds ratio; RR: risk ratio
aAccording to each trial's criteria, non-inferiority was met in DIRECT-MT and DEVT, whereas this was not the case for all other trials.
bDefinitions of symptomatic intracranial haemorrhage varied across studies.