Table 4 Assessment of Evidence Certainty using GRADE
Summary of findings: | ||||||
|---|---|---|---|---|---|---|
Short-stay compared to usual care for total hip and knee replacement | ||||||
Patient or population: Adults ≥ 18 years undergoing elective THR or knee replacement (unilateral, bilateral, total, unicompartmental) Setting: Any setting that utilised a short-stay programme Intervention: Short-stay Comparison: Usual care | ||||||
Outcome № of participants (studies) | Relative effect (95% CI) | Anticipated absolute effects (95% CI) | Certainty | What happens | ||
Without Short-Stay | With Short-Stay | Difference | ||||
Blood transfusion № of participants: 57 (1 RCT) | OR 1.75 (0.27 to 11.36) | 6.7% | 11.1% (1.9 to 44.8) | 4.4% more (4.8 fewer to 38.1 more) | ⨁⨁◯◯ Lowa,b | Short-stay programmes may result in little to no difference in blood transfusion |
Other Complications № of participants: 147 (3 RCTs) | OR 0.63 (0.26 to 1.53) | 23.0% | 15.8% (7.2 to 31.3) | 7.2% fewer (15.8 fewer to 8.4 more) | ⨁⨁◯◯ Lowb | Short-stay programmes may result in little to no difference in other complications |
Hospital Readmissions № of participants: 98 (2 RCTs) | OR 0.95 (0.12 to 7.46) | 4.0% | 3.8% (0.5 to 23.7) | 0.2% fewer (3.5 fewer to 19.7 more) | ⨁⨁◯◯ Lowb | Short-stay programmes may result in little to no difference in hospital readmissions |
Stiffness and/or anipulation № of participants: 90 (2 RCTs) | OR 1.57 (0.18 to 13.26) | 2.3% | 3.5% (0.4 to 23.6) | 1.2% more (1.9 fewer to 21.3 more) | ⨁⨁◯◯ Lowb | Short-stay programmes may result in little to no difference in stiffness and/or manipulation |
Neurovascular Injury № of participants: 49 (1 RCT) | OR 0.31 (0.01 to 7.92) | 4.2% | 1.3% (0 to 25.6) | 2.8% fewer (4.1 fewer to 21.4 more) | ⨁⨁◯◯ Lowa,b | Short-stay programmes may result in little to no difference in neurovascular injury |
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI) CI confidence interval, OR odds ratio | ||||||
GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect | ||||||