GRADE summary of evidence for thrombolysis followed by AC vs AC alone in patients with submassive PE
| No. of studies . | Study design . | No. of patients (%) . | Effect . | Certainty . | Importance . | ||
|---|---|---|---|---|---|---|---|
| Thrombolysis followed by AC . | AC alone . | Relative (95% CI) . | Absolute (95% CI) . | ||||
| Mortality (assessed with: all-cause mortality) | |||||||
| 120 | Nonrandomized studies | 0/14 (0.0) | 1/9 (11.1) | Not estimable | Not estimable | ⊕○○○ Very low | Critical |
| Thrombus resolution (follow-up: 6 months; assessed with: complete or partial resolution) | |||||||
| 121 | Nonrandomized studies | 5/5 (100.0) | 3/3 (100.0) | RR, 1.00 (0.64-1.56) | 0 fewer per 1000 (360 fewer to 560 more) | ⊕○○○ Very low∗,† | Critical |
| Progression (submassive to massive) | |||||||
| 120 | Nonrandomized studies | 1/14 (7.1) | 1/9 (11.1) | RR, 0.64 (0.05-9.03) | 40 fewer per 1000 (106 fewer to 892 more) | ⊕○○○ Very low∗,† | Critical |
| Chronic thromboembolic pulmonary hypertension (follow-up: 6 months) | |||||||
| 121 | Nonrandomized studies | 0/5 (0.0) | 0/2 (0.0) | Not estimable | Not estimable | ⊕○○○ Very low∗,† | Critical |
| Bleeding (assessed with: unspecified) | |||||||
| 220,21 | Nonrandomized studies | 0/19 (0.0) | 0/9 (0.0) | Not pooled | Not estimable | ⊕○○○ Very low∗,† | Critical |
| No. of studies . | Study design . | No. of patients (%) . | Effect . | Certainty . | Importance . | ||
|---|---|---|---|---|---|---|---|
| Thrombolysis followed by AC . | AC alone . | Relative (95% CI) . | Absolute (95% CI) . | ||||
| Mortality (assessed with: all-cause mortality) | |||||||
| 120 | Nonrandomized studies | 0/14 (0.0) | 1/9 (11.1) | Not estimable | Not estimable | ⊕○○○ Very low | Critical |
| Thrombus resolution (follow-up: 6 months; assessed with: complete or partial resolution) | |||||||
| 121 | Nonrandomized studies | 5/5 (100.0) | 3/3 (100.0) | RR, 1.00 (0.64-1.56) | 0 fewer per 1000 (360 fewer to 560 more) | ⊕○○○ Very low∗,† | Critical |
| Progression (submassive to massive) | |||||||
| 120 | Nonrandomized studies | 1/14 (7.1) | 1/9 (11.1) | RR, 0.64 (0.05-9.03) | 40 fewer per 1000 (106 fewer to 892 more) | ⊕○○○ Very low∗,† | Critical |
| Chronic thromboembolic pulmonary hypertension (follow-up: 6 months) | |||||||
| 121 | Nonrandomized studies | 0/5 (0.0) | 0/2 (0.0) | Not estimable | Not estimable | ⊕○○○ Very low∗,† | Critical |
| Bleeding (assessed with: unspecified) | |||||||
| 220,21 | Nonrandomized studies | 0/19 (0.0) | 0/9 (0.0) | Not pooled | Not estimable | ⊕○○○ Very low∗,† | Critical |
ROBINS-I, Risk Of Bias in Nonrandomized Studies-of Interventions.
Risk of bias, assessed using ROBINS-I, was judged to be serious because of selection bias without adjustment for potential confounders.
Imprecision because of the small number of included patients and patients with events in the included studies.