Table 2 GRADE analysis for quality of evidence.

From: Efficacy and safety of direct oral anticoagulants for secondary prevention of cancer associated thrombosis: a meta-analysis of randomized controlled trials

Outcome

Certainty Assessment

Patients

Anticipated effects

Certainty

Number studies

Study design

Risk of bias

Inconsistency

Indirectness

Imprecision

Other

DOAC

Other AC

Relative risk (95% CI)

Absolute risk reduction with DOAC (95% CI)

DOAC compared to VKA/LMWH

VTE

10

RCT

Not serious

Not serious

Not serious

Not serious

None

5.6% (119/2125)

9.0% (187/2068)

0.63 (0.51–0.79)

33 fewer per 1000 (44 fewer to 19 fewer)

      

High

MB

9

RCT

Not serious

Not serious

Not serious

Not serious

None

4.3% (86/2008)

4.0% (78/1958)

1.01 (0.65–1.56)

0 fewer per 1000 (14 fewer to 22 more)

      

High

CRNMB

9

RCT

Not serious

Not serious

Not serious

Not serious

None

11.7% (235/2008)

8.9% (174/1958)

1.28 (0.95–1.73)

25 more per 1000 (4 fewer to 65 more)

      

High

All bleed

10

RCT

Not serious

Not serious

Not serious

Not serious

None

16.1% (341/2117)

13.5% (277/2057)

1.11 (0.84–1.46)

15 more per 1000 (22 fewer to 62 more)

      

High

DOAC compared to LMWH

VTE

4

RCT

Not serious

Not serious

Not serious

Not serious

None

5.9% (86/1446)

9.9% (143/1448)

0.57 (0.40–0.83)

42 fewer per 1000 (59 fewer to 17 fewer)

      

High

MB

4

RCT

Not serious

Not serious

Not serious

Not serious

None

4.8% (69/1446)

3.7% (53/1448)

1.31 (0.78–2.18)

11 more per 1000 (8 fewer to 43 more)

      

High

CRNMB

4

RCT

Not serious

Not serious

Not serious

Not serious

None

11.2% (162/1446)

7.3% (106/1448)

1.6 (1.13–2.26)

44 more per 1000 (10 more to 92 more)

      

High

All bleed

4

RCT

Not serious

Not serious

Not serious

Not serious

None

16.0% (231/1446)

11.0% (159/1448)

1.49 (1.1–2.01)

54 more per 1000 (11 more to 111 more)

      

High

DOAC compared to VKA

VTE

6

RCT

Not serious

Not serious

Not serious

Not serious

None

4.9% (33/679)

7.1% (44/620)

0.69 (0.44– 1.06)

22 fewer per 1000 (40 fewer to 4 more)

      

High

MB

5

RCT

Not serious

Not serious

Not serious

Not serious

None

3.0% (17/562)

4.9% (25/510)

0.62 (0.34– 1.14)

19 fewer per 1000 (32 fewer to 7 more)

      

High

CRNMB

5

RCT

Not serious

Not serious

Not serious

Not serious

None

13.0% (73/562)

13.3% (68/510)

0.95 (0.63– 1.41)

7 fewer per 1000 (49 fewer to 55 more)

      

High

All bleed

6

RCT

Not serious

Not serious

Not serious

Not serious

None

16.4% (110/671)

19.4% (118/609)

0.84 (0.65– 1.08)

31 fewer per 1000 (68 fewer to 16 more)

      

High

  1. VTE (recurrent) venous thromboembolism, MB major bleeding, CRNMB clinically relevant non major bleeding, all bleeding MB + CRNMB, DOAC direct oral anticoagulant, other AC other anticoagulant (VKA or LMWH).