Table 3.

Summary of findings for DOACs vs LMWHs for the treatment of cancer-associated thrombosis in patients with incidental VTE

OutcomeNo. of participants (studies)Certainty of the evidence (GRADE)RR (95% CI)Observed risk with LMWHAnticipated absolute effects
Risk with DOACs*Absolute risk difference
Recurrent VTE 774 (3 RCTs) ⊕⊕⊕◯ MODERATE due to imprecision 0.54 (0.26 to 1.11) 6.4% 3.5% −2.9% (–4.7 to 0.7) 
Major bleeding 774 (3 RCTs) ⊕⊕⊕◯ MODERATE due to imprecision 1.29 (0.74 to 2.28) 4.6% 5.9% 1.3% (–1.2 to 5.9) 
OutcomeNo. of participants (studies)Certainty of the evidence (GRADE)RR (95% CI)Observed risk with LMWHAnticipated absolute effects
Risk with DOACs*Absolute risk difference
Recurrent VTE 774 (3 RCTs) ⊕⊕⊕◯ MODERATE due to imprecision 0.54 (0.26 to 1.11) 6.4% 3.5% −2.9% (–4.7 to 0.7) 
Major bleeding 774 (3 RCTs) ⊕⊕⊕◯ MODERATE due to imprecision 1.29 (0.74 to 2.28) 4.6% 5.9% 1.3% (–1.2 to 5.9) 

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). RCTs, randomized controlled trials.

*

The risk in the DOAC group (and its 95% CI) is based on the observed risk in the LMWH group and the relative effect of the intervention (and its 95% CI).

Graded down for imprecision due to a broad 95% CI with a possible positive and negative effect of DOAC vs LMWH.

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