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Table 3 Rating of quality of evidence with GRADE system

From: Comparison of vaginal hysterectomy and laparoscopic hysterectomy: a systematic review and meta-analysis

Certainty assessment Number of patients Effect Certainty Importance
Number of studies Study design Risk of bias Inconsistency Indirectness Imprecision Other considerations LH VH Relative (95% CI) Absolute (95% CI)
Overall complications
17 randomised trials serious† not serious not serious not serious none 169/887 (19.1%) 212/1055 (20.1%) RR 1.11 (0.85 to 1.45) 22 more per 1000 (from 30 fewer to 90 more) MODERATE none
Grade I complications
17 randomised trials serious† not serious not serious not serious none 128/887 (14.4%) 144/1055 (13.6%) RR 1.20 (0.90 to 1.61) 27 more per 1000 (from 14 fewer to 83 more) MODERATE none
Grade II complications
17 randomised trials serious† not serious not serious not serious none 29/887 (3.3%) 55/1055 (5.2%) RR 0.78 (0.49 to 1.24) 11 fewer per 1000 (from 13 more to 27 fewer) MODERATE none
Grade III complications
17 randomised trials serious† not serious not serious not serious none 12/887 (1.4%) 14/1055 (1.3%) RR 1.03 (0.49 to 2.16) 0 fewer per 1000 (from 7 fewer to 15 more) MODERATE none
Urinary tract injuries
17 randomised trials serious† not serious not serious not serious none 9/781 (1.2%) 10/1020 (1.0%) RR 1.20 (0.50 to 2.85) 2 more per 1000 (from 5 fewer to 18 more) MODERATE none
Operating time
18 randomised trials serious† not serious not serious not serious none 922 1089 MD 34.01 h lower (45.54 lower to 24.48 lower) MODERATE none
Length of hospital stay
14 randomised trials serious‡ serious§c not serious not serious none 636 809 MD 6.57 h lower (18.65 lower to 5.5 higher) LOW none
Blood loss
16 randomised trials serious† serious§ not serious not serious none 595 598 MD 35.91 mL lower (102.26 lower to 30.43 higher) LOW none
Intraoperative conversion
7 randomised trials serious† not serious not serious not serious none 15/771 (1.9%) 24/939 (2.6%) RR 0.94 (0.49 to 1.81) 2 fewer per 1000 (from 13 fewer to 21 more) MODERATE none
Recuperation
4 randomised trials serious‡ serious§ not serious not serious none 130 130 MD 0.66 days higher (0.77 lower to 0.9 higher) LOW none
Pain on day of surgery (assessed with: Visual analogue scale)
5 randomised trials serious† not serious not serious not serious none 325 491 MD 0.8 higher (0.08 lower to 1.68 higher) MODERATE none
Pain at 24 h after surgery (assessed with: Visual analogue scale)
4 randomised trials serious† not serious not serious not serious none 155 157 MD 0.53 lower (0.7 lower to 0.35 lower) MODERATE none
Pain at 48 h after surgery (assessed with: Visual analogue scale)
4 randomised trials serious† not serious not serious not serious none 295 461 MD 0.2 lower (0.61 lower to 0.22 higher) MODERATE none
  1. CI Confidence interval, RR risk ratio, and MD mean difference
  2. † High risk of allocation and blinding
  3. ‡ High risk of blinding and incomplete outcome data
  4. § High heterogeneity