| Quality assessment | No of patients | Effect | Quality | Importance | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| No of studies | Design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | Surgery | Conservative treatment (NRS) | Relative (95% CI) | Absolute | ||
| Mortality | ||||||||||||
| 2 | observational studies | very seriousa | no serious inconsistency | no serious indirectness | no serious imprecision | none | - | -c | HR 0.65 (0.57 to 0.74) | -3 | VERY LOW | CRITICAL |
| Fractures | ||||||||||||
| 2 | observational studies | very seriousa | no serious inconsistency | no serious indirectness | Seriousb | none | - | -c | HR 0.67 (0.55 to 0.82) | -3 | VERY LOW | CRITICAL |
| Cancer | ||||||||||||
| 1 | observational studies | very seriousa | no serious inconsistency | no serious indirectness | Seriousb | None |
135/1934 (7%) |
119/1279 (9.3%) | HR1.11 (0.9 to 1.37) | 10 more per 1000 (from 9 fewer to 32 more) | VERY LOW | IMPORTANT |
| Kidney stones | ||||||||||||
| 1 | observational studies | very seriousa | no serious inconsistency | no serious indirectness | no serious imprecision | None |
297/1934 (15.4%) |
83/1279 (6.5%) | HR 1.87 (1.3 to 2.69) | 53 more per 1000 (from 19 more to 100 more) | VERY LOW | CRITICAL |
Downgraded by 1 increment if the majority of studies were at high risk of bias, and downgraded by 2 increments if the majority of studies were at very high risk of bias
Downgraded by 1 increment if the confidence interval crossed 1 MID, and downgraded by 2 increments if the confidence interval crossed both MIDs
Control group rate not reported
From: Evidence review for indications for surgery
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