Presentation is loading. Please wait.

Presentation is loading. Please wait.

Volume 149, Issue 4, Pages e12 (October 2015)

Similar presentations


Presentation on theme: "Volume 149, Issue 4, Pages e12 (October 2015)"— Presentation transcript:

1 Volume 149, Issue 4, Pages 958-970.e12 (October 2015)
Comparative Effectiveness of Pharmacological Interventions for Severe Alcoholic Hepatitis: A Systematic Review and Network Meta-analysis  Siddharth Singh, Mohammad Hassan Murad, Apoorva K. Chandar, Connie M. Bongiorno, Ashwani K. Singal, Stephen R. Atkinson, Mark R. Thursz, Rohit Loomba, Vijay H. Shah  Gastroenterology  Volume 149, Issue 4, Pages e12 (October 2015) DOI: /j.gastro Copyright © 2015 AGA Institute Terms and Conditions

2 Figure 1 Flow sheet summarizing study identification and selection. CS, corticosteroids; PTX, pentoxifylline; RCT, randomized controlled trial. Gastroenterology  , e12DOI: ( /j.gastro ) Copyright © 2015 AGA Institute Terms and Conditions

3 Figure 2 Evidence network of different pharmacological interventions for decreasing short-term mortality in patients with severe alcoholic hepatitis. The numbers (and numbers in parentheses) refer to the number of trials (and number of combined number of participants in these trials), and the thickness of the connecting line corresponds to the number of trials between comparators. Gastroenterology  , e12DOI: ( /j.gastro ) Copyright © 2015 AGA Institute Terms and Conditions

4 Supplementary Figure 1 Quality assessment of included studies. (A) Overall and (B) study-level risk of bias, using Cochrane’s risk of bias assessment tool. In this tool, studies were deemed to be at high, low, or unclear risk of bias based on adequacy of sequence generation, allocation concealment, blinding, method of addressing incomplete data, selective reporting, and other biases. The review authors' judgments about each risk of bias item are presented as percentages across all included studies and for each included study. For mortality (which is highly unlikely to be influenced by performance bias or detection bias), open-label or single-blinded studies were not considered at high risk of bias, even if patients, physicians, and/or outcome assessors were not blinded, in accordance with the Cochrane handbook. Gastroenterology  , e12DOI: ( /j.gastro ) Copyright © 2015 AGA Institute Terms and Conditions

5 Supplementary Figure 1 Quality assessment of included studies. (A) Overall and (B) study-level risk of bias, using Cochrane’s risk of bias assessment tool. In this tool, studies were deemed to be at high, low, or unclear risk of bias based on adequacy of sequence generation, allocation concealment, blinding, method of addressing incomplete data, selective reporting, and other biases. The review authors' judgments about each risk of bias item are presented as percentages across all included studies and for each included study. For mortality (which is highly unlikely to be influenced by performance bias or detection bias), open-label or single-blinded studies were not considered at high risk of bias, even if patients, physicians, and/or outcome assessors were not blinded, in accordance with the Cochrane handbook. Gastroenterology  , e12DOI: ( /j.gastro ) Copyright © 2015 AGA Institute Terms and Conditions

6 Supplementary Figure 2 Direct meta-analysis of different pharmacological interventions for (A) decreasing short-term mortality (1 month), (B) medium-term mortality (3-12 months), (C) acute kidney injury and (D) infections in patients with severe alcoholic hepatitis. Please note that in the forest plot, ‘experimental’ refers to first treatment group, whereas “control” refers to the second treatment group. Gastroenterology  , e12DOI: ( /j.gastro ) Copyright © 2015 AGA Institute Terms and Conditions

7 Supplementary Figure 2 Direct meta-analysis of different pharmacological interventions for (A) decreasing short-term mortality (1 month), (B) medium-term mortality (3-12 months), (C) acute kidney injury and (D) infections in patients with severe alcoholic hepatitis. Please note that in the forest plot, ‘experimental’ refers to first treatment group, whereas “control” refers to the second treatment group. Gastroenterology  , e12DOI: ( /j.gastro ) Copyright © 2015 AGA Institute Terms and Conditions

8 Supplementary Figure 2 Direct meta-analysis of different pharmacological interventions for (A) decreasing short-term mortality (1 month), (B) medium-term mortality (3-12 months), (C) acute kidney injury and (D) infections in patients with severe alcoholic hepatitis. Please note that in the forest plot, ‘experimental’ refers to first treatment group, whereas “control” refers to the second treatment group. Gastroenterology  , e12DOI: ( /j.gastro ) Copyright © 2015 AGA Institute Terms and Conditions

9 Supplementary Figure 2 Direct meta-analysis of different pharmacological interventions for (A) decreasing short-term mortality (1 month), (B) medium-term mortality (3-12 months), (C) acute kidney injury and (D) infections in patients with severe alcoholic hepatitis. Please note that in the forest plot, ‘experimental’ refers to first treatment group, whereas “control” refers to the second treatment group. Gastroenterology  , e12DOI: ( /j.gastro ) Copyright © 2015 AGA Institute Terms and Conditions

10 Supplementary Figure 3 Ranking probabilities of treatment for severe alcoholic hepatitis, for short-term mortality. Gastroenterology  , e12DOI: ( /j.gastro ) Copyright © 2015 AGA Institute Terms and Conditions

11 Supplementary Figure 4 Funnel plot of trials of severe alcoholic hepatitis. There is no evidence of funnel plot asymmetry, arguing against significant publication bias. Gastroenterology  , e12DOI: ( /j.gastro ) Copyright © 2015 AGA Institute Terms and Conditions


Download ppt "Volume 149, Issue 4, Pages e12 (October 2015)"

Similar presentations


Ads by Google