GRADE guidelines 27: how to calculate absolute effects for time-to-event outcomes in summary of findings tables and Evidence Profiles

1 has resulted in more than 3 million cases and more than 210 000 deaths worldwide. 2 The World Health Organization (WHO) has declared the COVID-19 outbreak a pandemic. The pathogen, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), 3 is a novel Betacoronavirus that shares a phylogenetic similarity to SARS-CoV (about 79%) and Middle East respiratory syndrome (MERS)-CoV (about 50%). 4,5 Many clinical trials of potential COVID-19 treatments are underway, but current strategies for treatment are based to a considerable extent on preclinical studies and previous experi ences from SARS and MERS. 6 Clinicians have administered a number of antiviral treatments to patients with COVID-19. 7 Optimal decision-making regarding these agents requires systematic summaries of the best available evidence about antiviral agents. RESEARCHEfficacy and safety of antiviral treatment for COVID-19 from evidence in studies of SARS-CoV-2 and other acute viral infections: a systematic review and meta-analysis

show abstract

“…Where hazard ratios (HRs) were provided, we estimated risk of an event in the intervention group from HRs and risk in the control group. 12…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of antiviral treatment for COVID-19 from evidence in studies of SARS-CoV-2 and other acute viral infections: a systematic review and meta-analysis

Liu

Zhou

Chen

et al. 2020

CMAJ

View full text Add to dashboard Cite

show abstract

“…The estimation of risk differences was performed indirectly from the pooled hazard ratios and the estimation of the baseline risk. For the latter, data was obtained from Kaplan Meier survival curves from the control groups [ 31 ] . We used Review Manager v.5.3 [ 32 ] for the estimation of pooled hazard ratios, and we used GRADEpro [ 33 ] for the estimation of the absolute difference of events.…”

Section: Methodsmentioning

confidence: 99%

Adherence to breast cancer guidelines is associated with better survival outcomes: a systematic review and meta-analysis of observational studies in EU countries

Ricci‐Cabello

Vásquez-Mejía

Canelo‐Aybar

et al. 2020

BMC Health Serv Res

View full text Add to dashboard Cite

Background Breast cancer (BC) clinical guidelines offer evidence-based recommendations to improve quality of healthcare for patients with or at risk of BC. Suboptimal adherence to recommendations has the potential to negatively affect population health. However, no study has systematically reviewed the impact of BC guideline adherence -as prognosis factor- on BC healthcare processes and health outcomes. The objectives are to analyse the impact of guideline adherence on health outcomes and on healthcare costs. Methods We searched systematic reviews and primary studies in MEDLINE and Embase, conducted in European Union (EU) countries (inception to May 2019). Eligibility assessment, data extraction, and risk of bias assessment were conducted by one author and crosschecked by a second. We used random-effects meta-analyses to examine the impact of guideline adherence on overall survival and disease-free survival, and assessed certainty of evidence using GRADE. Results We included 21 primary studies. Most were published during the last decade (90%), followed a retrospective cohort design (86%), focused on treatment guideline adherence (95%), and were at low (80%) or moderate (20%) risk of bias. Nineteen studies (95%) examined the impact of guideline adherence on health outcomes, while two (10%) on healthcare cost. Adherence to guidelines was associated with increased overall survival (HR = 0.67, 95%CI 0.59–0.76) and disease-free survival (HR = 0.35, 95%CI 0.15–0.82), representing 138 more survivors (96 more to 178 more) and 336 patients free of recurrence (73 more to 491 more) for every 1000 women receiving adherent CG treatment compared to those receiving non-adherent treatment at 5 years follow-up (moderate certainty). Adherence to treatment guidelines was associated with higher costs, but adherence to follow-up guidelines was associated with lower costs (low certainty). Conclusions Our review of EU studies suggests that there is moderate certainty that adherence to BC guidelines is associated with an improved survival. BC guidelines should be rigorously implemented in the clinical setting. Trial registration PROSPERO (CRD42018092884).

show abstract

“…Using IMRT instead of 3D radiotherapy was shown to increase some survival-related outcomes while reducing some side-effects of the radiation. Although we identified only lowquality evidence to support the use of radiotherapy boost, an RCT served as the basis to show that there were no significant differences with respect to OS, DSS, DFS and CFS between a standarddose (15 Gy) and a high-dose (20)(21)(22)(23)(24)(25) boost.…”

Section: Discussionmentioning

confidence: 99%

“…For time-to-event outcomes, we used the approach reported by Tierney et al [22] to estimate hazard ratios (HRs) and associated statistics appropriate for random-effects meta-analyses based on HRs reported in publications or, if these were not available, by manually extracting data from survival curves (as long as the number at risk was given). Absolute risks for the GRADE Summary-of-Findings (SoF) tables were calculated using the methods specified by Skoetz et al [23,24]. For dichotomous outcomes, we used the reported data to calculate risk ratios (RR) or odds ratios (OR), and for continuous outcomes we calculated mean differences (MD).…”

Section: Data Collection Data Items and Assumptionsmentioning

confidence: 99%

State of the art treatment for stage I to III anal squamous cell carcinoma: A systematic review and meta-analysis

Werner

Gaskins

Valle

et al. 2021

Radiotherapy and Oncology

View full text Add to dashboard Cite

GRADE guidelines 27: how to calculate absolute effects for time-to-event outcomes in summary of findings tables and Evidence Profiles

Cited by 48 publications

References 27 publications

Efficacy and safety of antiviral treatment for COVID-19 from evidence in studies of SARS-CoV-2 and other acute viral infections: a systematic review and meta-analysis

Efficacy and safety of antiviral treatment for COVID-19 from evidence in studies of SARS-CoV-2 and other acute viral infections: a systematic review and meta-analysis

Adherence to breast cancer guidelines is associated with better survival outcomes: a systematic review and meta-analysis of observational studies in EU countries

State of the art treatment for stage I to III anal squamous cell carcinoma: A systematic review and meta-analysis

Contact Info

Product

Resources

About