Evidence
This page contains a snapshot of featured content which highlights evidence addressing key clinical questions including areas of uncertainty. Please see the main topic reference list for details of all sources underpinning this topic.
BMJ Best Practice evidence tables
Evidence tables provide easily navigated layers of evidence in the context of specific clinical questions, using GRADE and a BMJ Best Practice Effectiveness rating. Follow the links at the bottom of the table, which go to the related evidence score in the main topic text, providing additional context for the clinical question. Find out more about our evidence tables.
This table is a summary of the analysis reported in a Cochrane Clinical Answer that focuses on the above important clinical question.
Confidence in the evidence is moderate or low to moderate where GRADE has been performed and there may be no difference in effectiveness between the intervention and comparison for key outcomes.
Population: People (where reported, mean age 56‐63 years; 73% men) with suspected or endoscopically verified upper gastrointestinal bleeding
Intervention: Tranexamic acid ᵃ
Comparison: Placebo ᵃ
| Outcome | Effectiveness (BMJ rating)? | Confidence in evidence (GRADE)? |
|---|---|---|
Mortality at 2-3 weeks ᵇ | Favours intervention | Moderate |
Rebleeding or continued bleeding at 2-3 weeks | No statistically significant difference | Low |
Surgery at 2-3 weeks | No statistically significant difference | Moderate |
Transfusion required at 2-3 weeks (post hoc analysis) | No statistically significant difference | Very Low |
Adverse events: composite of myocardial infarction, pulmonary embolism, and cerebral infarction | No statistically significant difference | GRADE assessment not performed for this outcome |
Adverse events: deep venous thrombosis | No statistically significant difference | GRADE assessment not performed for this outcome |
Adverse events: any thromboembolic event | No statistically significant difference | GRADE assessment not performed for this outcome |
Note ᵃ This evidence table summarises the findings for the comparison of tranexamic acid versus placebo, which is the main comparison as stated in the Cochrane review Summary of Findings table. See the full Cochrane Clinical Answer (CCA) for information on other comparisons (tranexamic acid versus cimetidine or lansoprazole). ᵇ The reviewers carried out a sensitivity analysis where in a worst‐case scenario analysis for this outcome (patients with missing outcome data were included as treatment failures) there was no statistically significant difference between groups (GRADE assessment not performed).
This evidence table is related to the following section/s:
Cochrane Clinical Answers
Cochrane Clinical Answers (CCAs) provide a readable, digestible, clinically focused entry point to rigorous research from Cochrane systematic reviews. They are designed to be actionable and to inform decision making at the point of care and have been added to relevant sections of the main Best Practice text.
- In people with upper gastrointestinal bleeding, what are the effects of tranexamic acid?
- Is there randomized controlled trial evidence to support the use of eradication therapy for healing peptic ulcer disease in Helicobacter pylori positive patients?
- Is there randomized controlled trial evidence to support the continuation of eradication therapy for preventing recurrence of peptic ulcer disease in previous Helicobacter pylori positive patients?
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