GRADE Evaluation of interventions for Trigeminal neuralgia.
Important outcomesAbility to perform normal activities, Pain relief, Psychological distress
Studies (Participants)OutcomeComparisonType of evidenceQualityConsistencyDirectnessEffect size for (ORs and RRs)GRADEComment
What are the effects of ongoing treatments in people with trigeminal neuralgia?
3 (208)[23]Pain reliefCarbamazepine versus placebo4–20–1+2ModerateQuality 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)[33]Pain reliefOxcarbazepine versus carbamazepine4–3000Very lowQuality points deducted for sparse data, incomplete reporting of results, and no direct comparison between groups
1 (14)[36]Pain reliefLamotrigine versus placebo4–20–10Very lowQuality 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.