GRADE Evaluation of interventions for Trigeminal neuralgia. Click
to find out how we arrive at our judgements about the quality of the evidence.
|Important outcomes||Ability to perform normal activities, Pain relief, Psychological distress
|Studies (Participants)||Outcome||Comparison||Type of evidence||Quality||Consistency||Directness||Effect size for (ORs and RRs)||GRADE||Comment
|What are the effects of ongoing treatments in people with trigeminal neuralgia?
|3 (208)||Pain relief||Carbamazepine versus placebo||4||–2||0||–1||+2||Moderate||Quality points deducted for crossover design and short follow-up; directness point deducted for inclusion of different pain severities and uncertainties about diagnostic criteria and outcomes measured; effect-size points added for RR = 5 or higher
|1 (48)||Pain relief||Oxcarbazepine versus carbamazepine||4||–3||0||0||0||Very low||Quality points deducted for sparse data, incomplete reporting of results, and no direct comparison between groups
|1 (14)||Pain relief||Lamotrigine versus placebo||4||–2||0||–1||0||Very low||Quality points deducted for sparse data and crossover design with no pre-crossover results; directness point deducted for concurrent use of other medication
|We initially allocate 4 points to evidence from RCTs, and 2 points to evidence from observational studies. To attain the final GRADE score for a given comparison, points are deducted or added from this initial score based on preset criteria relating to the categories of quality, directness, consistency, and effect size.
Quality: based on issues affecting methodological rigour (e.g., incomplete reporting of results, quasi-randomisation, sparse data [<200 people in the analysis]).
Consistency: based on similarity of results across studies.
Directness: based on generalisability of population or outcomes.
Effect size: based on magnitude of effect as measured by statistics such as relative risk, odds ratio, or hazard ratio.