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Table 2 Summary of findings

From: Uncertainty in the impact of liver support systems in acute-on-chronic liver failure: a systematic review and network meta-analysis

Summary of findings Quality of evidence
Intervention1 (Studies2) Rank Study event rates (%) Risk ratio (95% CrI) Anticipated absolute effects Overall certainty of evidence
With standard medical therapy3 With extracorporeal liver support devices4 Risk with standard medical therapy Risk difference with extracorporeal liver support devices
3-month overall survival (follow-up: range 84 days to 91 days)
 PE (2 RCTs) 1 334/569 (58.7%) 136/244 (55.7%) RR 0.74 (0.60 to 0.94) 59 per 100 15 fewer per 100 (from 23 to 4 fewer)
Very low
 MARS (2 RCTs) 2 12/17 (70.6%) RR 0.78 (0.38 to 1.40) 13 fewer per 100 (from 36 fewer to 23 more)
Very low
 Prometheus (1 RCT) 3 46/77 (59.7%) RR 0.97 (0.68 to 1.40) 2 fewer per 100 (from 19 fewer to 23 more)
Very low
 ELAD (4 RCTs) 4 78/213 (36.6%) RR 0.99 (0.76 to 1.30) 1 fewer per 100 (from 14 fewer to 18 more)
Very low
 BioLogic-DT (1 RCT) 5 5/5 (100.0%) RR 1.00 (0.55 to 2.10) 0 fewer per 100 (from 26 fewer to 65 more)
Very low
1 month overall survival (follow-up: range 28 days to 31 days)
 PE (1 RCT) 1 122/359 (34.0%) 19/104 (18.3%) RR 0.51 (0.12 to 2.40) 34 per 100 17 fewer per 100 (from 30 fewer to 48 more)
Moderate
 MARS (3 RCTs) 2 109/113 (96.5%) RR 0.60 (0.15 to 1.30) 14 fewer per 100 (from 29 fewer to 10 more)
Very low
 MARS + PE (indirect) 3 7/60 (11.7%) RR 0.60 (0.07 to 3.20) 14 fewer per 100 (from 32 fewer to 75 more)
Very low
 Prometheus (1 RCT) 4 29/77 (37.7%) RR 1.00 (0.25 to 4.30) 0 fewer per 100 (from 25 fewer to 100 more)
Very low
 BioLogic-DT (1 RCT) 6 6/10 (60.0%) RR 1.10 (0.24 to 5.40) 3 more per 100 (from 26 fewer to 100 more)
Very low
 ELAD (3 RCTs) 7 26/117 (22.2%) RR 1.40 (0.56 to 3.60) 14 more per 100 (from 15 fewer to 88 more)
Very low
3-month transplant-free survival (follow-up: range 84 days to 91 days)
 PE (1 RCT) 1 189/396 (47.7%) 42/104 (40.4%) RR 0.77 (0.51 to 1.10) 41 per 100 11 fewer per 100 (from 23 fewer to 5 more)
Moderate
 Prometheus (1 RCT) 2 52/77 (67.5%) RR 0.96 (0.67 to 1.40) 2 fewer per 100 (from 16 fewer to 19 more)
Very low
 ELAD (4 RCTs) 4 76/217 (35.0%) RR 1.00 (0.78 to 1.40) 0 fewer per 100 (from 11 fewer to 19 more)
VERY LOW
 MARS (1 RCT) 5 7/8 (87.5%) RR 1.10 (0.61 to 2.10) 5 more per 100 (from 19 fewer to 53 more)
Very low
1-month transplant-free survival (follow-up: range 28 days to 31 days)
 ELAD (2 RCTs) 1 109/264 (41.3%) 14/43 (32.6%) RR 0.47 (0.13 to 1.20) 41 per 100 22 fewer per 100 (from 36 fewer to 8 more)
Very low
 PE (1 RCT) 2 47/104 (45.2%) RR 0.52 (0.21 to 1.20) 20 fewer per 100 (from 33 fewer to 8 more)
Moderate
 MARS (3 RCTs) 3 60/122 (49.2%) RR 0.96 (0.50 to 1.50) 2 fewer per 100 (from 21 fewer to 21 more)
Very low
  1. Significant results are highlighted in italic
  2. CrI credible interval, PE plasma exchange, RCT randomized controlled trial, RR risk ratio, MARS molecular adsorbent and recirculating system, ELAD extracorporeal liver assist device
  3. 1Intervention compared to SMT as reference comparator
  4. 2Number of studies included in the direct comparison
  5. 3Data from all studies
  6. 4Data from studies included in the direct comparison