ORs less than unity indicated a treatment effect Avapritinib supplier that favored the study agent. Pooled, weighted ORs and their respective 95% CIs were then estimated separately per each outcome for each meta-analysis. In the RCTs that

have reported the severity of complications classified according to the Radiation Therapy Oncology Group (RTOG) or other score systems were combined when possible. Subgroup analyses for each outcome were performed by recalculating the ORs and 95% CIs, based on the clinical stage of the disease. We evaluated heterogeneity across trials using the I2 statistics, which describes the percentage of total variation across studies that are due to heterogeneity rather than chance [18]. The interpretation of I2 depends on the magnitude and direction of effects, as well as the strength

of www.selleckchem.com/products/MG132.html evidence for heterogeneity (e.g. P value from the chi-squared test, or a confidence interval for I2) [19]. We used the following classification based on the value of I2 [17, 18]: 0–30 = low; 30–60 = moderate and worthy of investigation; 60–90 = severe and worthy see more of understanding; 90–100 = allowing aggregation only with major caution. Publication bias is a common concern in meta-analysis, which is related to the tendency of journals to favor the publication of large and positive studies. Quality of the evidence has been assessed using the grade four-category system (high, moderate, low and very low quality) (Table 1). Factors that are considered in classifying evidence are: the study design and rigor of its execution, the consistency of results and how well the Methane monooxygenase evidence can be directly applied to patients, interventions, outcomes and comparator. Other important factors

are whether the data are sparse or imprecise and whether there is potential for reporting bias. Using this approach, assessments of the quality of evidence for each important outcome take into account the study design, limitations of the studies, consistency of the evidence across studies, the directness of the evidence, and the precision of the estimate [20, 21]. Table 1 Quality of the quality evidence, definitions and underlying methodology Grade Definition Underlying Methodology High Further research is very unlikely to change our confidence in the estimate of effect RCT or meta-analysis Moderate Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate Downgraded RCTs or upgraded observational studies Low have an important impact on our confidence in the estimate of effect an its likely to change the estimate Well-done observational studies with control groups Very low Any estimate of effect is very uncertain Others (e.g., case reports or case series) For each intervention considered, we formulated a consensus recommendation based on our judgments, regarding the balance between the benefits, harms (adverse effects), costs, and values and preferences of the intervention.