Authors and publication year | Pollock 200610 | Myrseth 200911 | Pollock 199512 | Myrseth 200515 | Regis 200214 | Karpinos 200213 |
---|---|---|---|---|---|---|
Design | Prospective consecutive predefined inclusion criteria | Prospective consecutive predefined inclusion criteria | Retrospective consecutive matched controls | Retrospective consecutive matched controls | Retrospective non-consecutive matched controls | Retrospective consecutive matched controls |
Allocation to treat arm | Preference patient | Preference patient | Preference patient and surgeon | Preference patient | 2 hospitals, preference by surgeon/patient | Miscellaneous criteria by surgeon |
Same primary endpoint: intervention-associated morbidity | Yes | Yes | Yes | Yes | Yes | Yes |
Selection of subjects | ||||||
Source population: adult, solitary VS<30 mm, no previous intervention | Yes | Yes | Yes | Yes | Yes | No |
Eligibility criteria: proven growth or predefined cisternal size | No | Yes | No | No | No | No |
Exclusion criteria NOT more strict for MS because of age and comorbidity | Yes | No | No | No | No | No |
Participation rate NOT lower for MS because of specific RS referral | Yes | No | No | No | No | No |
Same baseline cranial nerve deficits | Yes | Yes | Yes | Yes | No | Yes |
Consecutive series and loss to follow-up <10% | Yes | Yes | Yes | Yes | No | No |
Adequate analysis drop outs | Yes | Yes | No | Yes | No | No |
Outcome assessment | ||||||
Prespecified endpoint | Yes | Yes | Yes | Yes | Yes | Yes |
Mortality addressed | Yes | Yes | No | Yes | Yes | Yes |
Blinded outcome measurement | Yes | No | No | No | No | No |
Same measure new cranial nerve deficit | Yes | Yes | Yes | Yes | Yes | Yes |
Same measure quality-of-life scores | Yes | Yes | Yes | Yes | Yes | No |
Repeated outcome measurement | Yes | Yes | Yes | Yes | Yes | No |
Confounding variables | ||||||
NOT substantial larger tumour size in MS arm | Yes | Yes | Yes | Yes | Yes | No |
NOT substantial higher age in RS arm | No | Yes | No | No | No | No |
NOT less fit patients in RS arm | Yes | No | No | No | No | No |
One single intervention in each arm | Yes | Yes | Yes | Yes | Yes | No |
Statistical analysis | ||||||
Statistical measure of precision | Yes | Yes | Yes | Yes | Yes | Yes |
Overall assessment | ||||||
Number of relevant ‘no’ | 0 | 0 | 0 | 0 | 3 | 6 |
Overall judgement | ++ | ++ | + | + | − | − |
No commercial funding | Yes | Yes | Yes | Yes | Yes | Yes |
No relevant bias, outcome owing to intervention | Yes | Yes | Yes | Yes | No | No |
Outcome applicable to source population | Yes | Yes | Yes | Yes | No | No |
Yes: well covered or adequately addressed, increasing confidence that outcome is caused by the interventions.
No: poorly or not addressed or not reported; cause for bias. Bold: possible relevant bias, decreasing confidence.
++, All or most of the criteria have been fulfilled. Where they have not been fulfilled the conclusions of the study or reviews are thought to be very unlikely to alter.
+, Some of the criteria have been fulfilled. Those criteria that have not been fulfilled or not adequately described are thought unlikely to alter the conclusions.
−, Few or no criteria fulfilled. The conclusions of the study are thought likely or very likely to alter.