SUMMARY OF FINDINGS FOR THE MAIN COMPARISON [Explanation]
| Routine preoperative medical testing compared with selective or no testing for cataract surgery | |||||
|---|---|---|---|---|---|
|
Population: adults with age-related cataract Settings: hospital or clinic Intervention: routine preoperative medical testing Comparison: selective or no preoperative medical testing | |||||
| Outcomes | Illustrative comparative risks* (95% Cl) | Relative effect (95% Cl) | No. of participants (studies) | Certainty of the evidence (GRADE) | |
| Assumed risk | Corresponding risk | ||||
| Selective or no testing | Preoperative medical testing | ||||
|
Medical adverse events up to 2 months after surgery |
33 per 1000 |
33 per 1000 (28 to 38) |
OR 1.00 (0.86 to 1.16) |
21,531 (3 studies) |
⊕⊕⊕⊕ high |
|
Ocular adverse events up to 2 months after surgery |
Intraoperative |
OR 0.99 (0.71 to 1.38) |
2281 (2 studies) |
⊕⊕⊕○ moderate1 |
|
| 69 per 1000 |
68 per 1000 (49 to 96) |
||||
| Postoperative |
OR 1.11 (0.74 to 1.67) |
||||
| 43 per 1000 |
48 per 1000 (32 to 72) |
||||
|
Cost for preoperative testing prior to surgery |
BRL 4.32 per patient | BRL 11.00 per patient | Ratio 2.55 | 1005 (1 study) |
⊕⊕⊕○ moderate2 |
|
Cancellation of cataract surgery prior to surgery |
16 per 1000 |
16 per 1000 (13 to 20) |
OR 0.97 (0.78 to 1.21) |
20,582 (2 studies) |
⊕⊕⊕⊕ high |
|
Clinical management changes (other than cancellation) prior to surgery |
Not reported by any included study | ||||
|
Quality of life outcomes at any follow-up time point |
Not reported by any included study | ||||
| *The basis for the assumed risk is the comparison group risk across studies. The corresponding risk (and its 95%CI) is based on the assumed risk in the comparison group and the relative effect of the intervention group (and its 95%CI). Cl: confidence interval; OR: odds ratio | |||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | |||||
1
Downgraded for imprecision of the estimate (i.e. wide confidence intervals).
2
Downgraded for reporting bias due to lack of information regarding the confidence interval around the effect estimate.