The grade quality assessment for metoprolol versus placebo or non-treatment group
| Metoprolol compared with placebo or non-treatment for postoperative atrial fibrillation prophylaxis | ||||||
| Patient or population: cardiac surgery Intervention: metoprolol Comparison: placebo or non-treatment | ||||||
| Outcomes | Anticipated absolute effects (95% CI)* | Relative effect (95% CI) | No of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with placebo | Risk with metoprolol | |||||
| Postoperative atrial fibrillation | Study population | RR 0.46 (0.32 to 0.66) (p <0.001) | 416 (3 RCTs) | ⊕⊕⊕⊕ HIGH | Assumed risk calculated from the mean risk across the control groups | |
| 358 per 1000 | 165 per 1000 (115 to 236) | |||||
| Hypotension | Study population | RR 1.70 (0.41 to 7.16) (p =0.860) | 327 (2 RCTs) | ⊕⊕⊕⊕ HIGH | Assumed risk calculated from the mean risk across the control groups | |
| 12 per 1000 | 21 per 1000 (5 to 87) | |||||
| Bradycradia | Study population | RR 2.55 (0.99 to 6.60) (p =0.080) | 327 (2 RCTs) | ⊕⊕⊕⊕ HIGH | Assumed risk calculated from the mean risk across the control groups | |
| 30 per 1000 | 77 per 1000 (30 to 200) | |||||
GRADE Working Group grades of evidence.
High certainty: We are very confident that the true effect lies close to that of the estimate of the effect.
Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.
Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect.
Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect.
*The risk in the intervention group (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
GRADE, grading of recommendations assessment, development and evaluation; RCTs, randomised controlled trials; RR, risk ratio.