Summary of findings table for PICO 2
| Certainty assessment | No of patients | Effect | Quality of evidence | Importance | ||||||||
| No of studies | Study design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | MT+BMM | BMM alone | Relative (95% CI) | Absolute (95% CI) | ||
| mRS score 0–2 | ||||||||||||
| 2 | Randomized trials | Not serious | Serious | Serious | Not serious | Strong association | 93/199 (46.7%) | 28/189 (14.8%) |
RR=3.12
(2.15 to 4.53) OR=5.01 (3.07 to 8.17) |
314 more per 1 000
(from 170 more to 523 more) | ⨁⨁⨁ MODERATE* | CRITICAL |
The RR and OR presented in the table correspond to our aggregate data meta-analysis of DAWN and DEFUSE-3.
BMM, best medical management; CI, confidence interval; MT, mechanical thrombectomy; RR, risk ratio.
*Explanation:
The overall quality of evidence (QoE) to provide recommendations for the 6-24h time window was rated as moderate for the following reasons:
Starting with a high QoE due to the randomized trial design, the QoE was downgraded by one step due to indirectness because the DEFUSE-3 trial did not enroll patients beyond 16hours
The QoE was rated up by one step due to a strong association (pooled RR larger than 2.0)
Although there was no evidence of heterogeneity in our meta-analysis, we still considered the risk of inconsistency due to other bias to be serious because of the varying inclusion and exclusion criteria across trials.