Systematic review of the literature from 1966 – June 2006 using MEDLINE and EmBASE
Description of studies
Study quality assessments, levels of evidence and grades of recommendation
Recommendations are graded according to the overall level of evidence (LoE) on which the recommendations are based, which is determined by the quality and source of evidence: Levels of evidence and grades of recommendation in PROSPECT reviews (from 2006)
Click here for quality scores and levels of evidence for included procedure-specific studies: Haemorrhoid Surgery June 2006 Quality Scoring + Levels of Evidence
No meta-analyses were performed due to a limited number of studies of homogeneous design that reported similar outcome measures. Therefore, the procedure-specific evidence was only assessed qualitatively.
Transferable evidence of analgesic efficacy from comparable procedures (e.g. anorectal surgery) or evidence of other outcomes, such as adverse effects, has been included to support the procedure-specific evidence where this is insufficient to formulate the recommendations. Several studies that were identified in the literature search reported data pooled from patients undergoing mixed surgical procedures including haemorrhoid surgery. Such studies are excluded from the procedure-specific systematic review, but have been used as additional transferable evidence in cases where the Working Group considered it appropriate.