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Table 2 Quality of evidence according to the GRADE criteria

From: Pin vs plate fixation for metacarpal fractures: a meta-analysis

Outcomes Number of studies (design); no. of participants Effect size (95% CI) Characteristics of the included studies  
Risk of biasa Inconsistency Indirectnessb Imprecisionc Publication bias Overall GRADE quality score
Disabilities of the arm, shoulder, and hand score (DASH) 6 (5 observational; 1 RCT); n = 329 WMD − 0.77 (− 3.55, 2.00) Serious Not serious Serious Not serious Undetected Low
Range of movement (ROM) at the meta-carpo-phalangeal joint 7 (6 observational; 1 RCT); n = 359 WMD 4.44 (− 4.19, 13.07) Serious Not serious Serious Not serious Undetected Low
Grip strength 4 (4 observational); n = 205 WMD − 4.63 (− 14.52, 5.26) Serious Not serious Serious Seriousc Undetected Very low
Limb shortening (in mm) on radiography 4 (4 observational); n = 219 WMD 1.25 (0.03, 2.47) Serious Not serious Serious Serious c Undetected Very low
Visual analogue score (VAS) 2 (2 observational); n = 107 WMD − 0.01 (− 0.27, 0.26) Serious Not serious Serious Seriousc Undetected Very low
Complication rates 8 (7 observational; 1 RCT); n = 439 RR 0.93 (0.57, 1.53) Serious Not serious Serious Not serious Undetected Low
  1. aMajority of the studies included were observational in design
  2. bStudies were done in different geographic settings. Further, studies differed in the age of the participants and the duration of follow-up post-operatively
  3. cCriteria for optimal information size (OIS) not met and the 95% CI overlap no effect and includes important benefit and harm