Effects of Anticoagulants on Experimental Models of Established Chronic Liver Diseases: A Systematic Review and Meta-Analysis
Table 2
The grading of the quality of evidence for each outcome.
Certainty assessment
No. of patients
Effect
Certainty
No. of studies
Study design
Risk of bias
Inconsistency
Indirectness
Imprecision
Other considerations
Anticoagulant therapies
Control
Relative (95% CI)
Absolute (95% CI)
Survival
4
Randomized trials
Seriousa
Not serious
Not serious
Not serious
None
143/197 (72.6%)
141/193 (73.1%)
RR 1.03 (0.94 to 1.13)
22 more per 1,000 (from 44 fewer to 95 more)
⊕⊕⊕⃝ moderate
Fibrosis evaluations by METAVIR fibrosis score system
3
Randomized trials
Very seriousa
Seriousb
Not serious
Not serious
Publication bias strongly suspectedc
37/61 (60.7%)
59/59 (100.0%)
RR 0.66 (0.47 to 0.94)
340 fewer per 1,000 (from 60 fewer to 530 fewer)
⊕⃝⃝⃝ very low
Collagen deposition
4
Randomized trials
Very seriousd
Very seriouse
Not serious
Not serious
Publication bias strongly suspectedc
142
120
—
MD −4.1 (−12.42, 4.23)
⊕⃝⃝⃝ very low
Portal pressure
3
Randomized trials
Very seriousa
Not serious
Not serious
Not serious
None
93
87
—
MD −1.39 (−2.33, −0.44)
⊕⊕⃝⃝ low
ALT
10
Randomized trials
Seriousf
Very seriousg
Not serious
Not serious
Publication bias strongly suspectedc
217
196
—
MD −82.7 (−107.36, −58.04)
⊕⃝⃝⃝ very low
AST
7
Randomized trials
Seriousd
Very serioush
Not serious
Not serious
Publication bias strongly suspectedc
141
130
—
MD −186.12 (−254.90, −117.33)
⊕⃝⃝⃝ very low
Total bilirubin
8
Randomized trials
Very seriousd
Very serioush
Not serious
Not serious
None
146
134
—
MD −0.96 (−1.46, −0.46)
⊕⃝⃝⃝ very low
Albumin
6
Randomized trials
Very seriousa
Very seriousi
Not serious
Not serious
None
98
88
—
MD 0.59 (0.16, 1.10)
⊕⃝⃝⃝ very low
TNF-α
1
Randomized trials
Very seriousa
Very seriousj
Not serious
Not serious
None
24
24
—
MD −169.69 (−257.64, −81.74)
⊕⃝⃝⃝ very low
CI, confidence interval; RR, risk ratio; MD, Mean difference; ALT, alanine aminotransferase; AST, aspartate aminotransferase. Explanations. a (1) All articles did not state detailed randomization method and blinding. (2) Due to poor description about experiment design and methods, many items (concealed allocation and selected outcome assessment, etc.) were “unclear.” bI2 = 71%. cSample size of the included studies was small and the funnel plot was asymmetric. d (1) All articles did not state a detailed randomization method. (2) Only one study stated blinding. (3) Due to poor description about experiment design and methods, many items (concealed allocation and selected outcome assessment, etc.) were “unclear.” eI2 = 98%. f (1) 40% articles did not state randomization and all articles did not state a detailed method. (2) Only one study stated blinding. (3) Due to poor description about experiment design and methods, many items (concealed allocation and selected outcome assessment, etc.) were “unclear.” gI2 = 97%. hI2 = 98%. iI2 = 94%. jI2 = 80%.