GRADE evidence profile for PICO 3
| Certainty assessment | № of patients | Effect | Certainty | Importance | ||||||||
| № | Study design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other | EVT plus BMT | BMT alone | Relative (95% CI) | Absolute (95% CI) | ||
| mRS 0–3 at 90 days | ||||||||||||
| 2 | Randomized trials | Serious* | Not serious | Serious†‡ | Not serious | None | NA | NA | aRR: 1.90 (1.41 to 2.57) | NA | ⨁⨁◯◯Low | CRITICAL |
| 5 | Prospective registries | Serious§ | Serious¶ | Serious† | Serious** | None | NA | NA | RR: 0.91 (0.50 to 1.67) | NA | ⨁◯◯◯Very low | CRITICAL |
| mRS 0–2 at 90 days | ||||||||||||
| 1 | Randomized trial | Serious* | NA†† | Serious‡ | Not serious | None | 43/110 | 15/107 | aRR 2.75 (1.65 to 4.56) | 25 more per 100 (from 14 to 36 more) | ⨁◯◯◯Very low | CRITICAL |
| 1 | Prospective registry | Moderate§ | NA†† | Not serious | Serious‡‡ | None | 36/154 | 1/46 | RR 10.75 (1.52 to 76.31) | 21 more per 100 (from 13 to 29 more) | ⨁◯◯◯Very low | CRITICAL |
| Shift (ordinal) mRS at 90 days | ||||||||||||
| 1 | Randomized trial | Serious* | NA†† | Serious‡ | Not serious | None | NA/110 | NA/107 | acOR 2.64 (1.54 to 4.50) | NA | ⨁◯◯◯Very low | CRITICAL |
| 1 | Prospective registry | Moderate§ | NA†† | Not serious | Serious‡‡ | None | NA | NA | cOR 4.1 (1.8 to 9.5) | NA | ⨁◯◯◯Very low | CRITICAL |
| Mortality at 90 days | ||||||||||||
| 1 | Randomized trial | Serious* | NA†† | Serious‡ | Serious** | None | 34/110 | 45/107 | aRR 0.75 (0.54 to 1.04) | Eleven fewer per 100 (from 24 fewer to two more) | ⨁◯◯◯Very low | CRITICAL |
| 1 | Prospective registry | Moderate§ | NA†† | Not serious | Not serious | None | 72/154 | 34/46 | RR 0.63 (0.50 to 0.80) | 27 fewer per 100 (42 to 12 fewer) | ⨁◯◯◯Very low | CRITICAL |
| Symptomatic Intracranial Hemorrhage (sICH) | ||||||||||||
| 1 | Randomized trial | Serious* | NA†† | Serious‡ | Very serious**‡‡ | None | 6/102 | 1/88 | RR 5.18 (0.64 to 42.18) | Five more per 100 (0 to 10 more) | ⨁◯◯◯Very low | CRITICAL |
| mTICI | ||||||||||||
| 1 | Randomized trial | Serious* | NA†† | Serious‡ | NA | None | 89/101 | NA | NA | NA | ⨁◯◯◯Very low | IMPORTANT |
*Serious risk of bias arising from the deviations from intended intervention in all RCTs, high risk of performance bias. Some concerns in other domains.
†Raw data was not available in one study; generic inverse variance meta-analysis of the reported RRs in the studies was performed.
‡Enrolled patients had mostly severe/very severe symptoms. Patients with mild-to-moderate symptoms were missing or underrepresented.
§Moderate risk of confounding and selection bias.
¶Presence of heterogeneity.
**Inconclusive confidence interval.
††Only one study included. Evaluation of inconsistency is not applicable (NA).
‡‡Wide confidence interval.
aRR, give details; BMT, give details; CI, confidence interval; EVT, give details; mRS, modified Rankin Scale; mTICI, modified Thrombolysis in Cerebral Ischemia; NA, not applicable; RCT, randomized controlled trial; RR, give details.