Surgical versus non‐surgical treatment for carpal tunnel syndrome

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Analysis 1.1

Comparison 1 Surgical versus non‐surgical treatment ‐ primary outcomes, Outcome 1 Improvement in clinical symptoms at three months.

Analysis 1.2

Comparison 1 Surgical versus non‐surgical treatment ‐ primary outcomes, Outcome 2 Improvement in clinical symptoms at six months.

Analysis 2.1

Comparison 2 Surgical versus non‐surgical treatment ‐ secondary outcomes, Outcome 1 Clinical improvement at one year of follow‐up.

Analysis 2.2

Comparison 2 Surgical versus non‐surgical treatment ‐ secondary outcomes, Outcome 2 Clinical improvement without including its relevance.

Analysis 2.3

Comparison 2 Surgical versus non‐surgical treatment ‐ secondary outcomes, Outcome 3 Need for surgery or secondary surgery during follow‐up.

Analysis 2.4

Comparison 2 Surgical versus non‐surgical treatment ‐ secondary outcomes, Outcome 4 Clinical improvement at less than three months.

Analysis 2.5

Comparison 2 Surgical versus non‐surgical treatment ‐ secondary outcomes, Outcome 5 Complications of surgery and medical treatment.

Analysis 2.6

Comparison 2 Surgical versus non‐surgical treatment ‐ secondary outcomes, Outcome 6 Improvement in neurophysiological parameters.

Table 1. Methodological quality of included studies

Table 1. Methodological quality of included studies

Comparison 1. Surgical versus non‐surgical treatment ‐ primary outcomes

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Improvement in clinical symptoms at three months Show forest plot	3	295	Risk Ratio (M‐H, Fixed, 95% CI)	1.23 [1.04, 1.46]

2 Improvement in clinical symptoms at six months Show forest plot	2	245	Risk Ratio (M‐H, Fixed, 95% CI)	1.19 [1.02, 1.39]

Comparison 1. Surgical versus non‐surgical treatment ‐ primary outcomes

Comparison 2. Surgical versus non‐surgical treatment ‐ secondary outcomes

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Clinical improvement at one year of follow‐up Show forest plot	2	198	Risk Ratio (M‐H, Fixed, 95% CI)	1.27 [1.05, 1.53]

2 Clinical improvement without including its relevance Show forest plot	1	50	Risk Ratio (M‐H, Fixed, 95% CI)	0.71 [0.43, 1.15]

2.1 Improvement in grip strength	1	50	Risk Ratio (M‐H, Fixed, 95% CI)	0.71 [0.43, 1.15]
3 Need for surgery or secondary surgery during follow‐up Show forest plot	2	198	Risk Ratio (M‐H, Fixed, 95% CI)	0.04 [0.01, 0.17]

4 Clinical improvement at less than three months Show forest plot	1	176	Risk Ratio (M‐H, Fixed, 95% CI)	0.64 [0.41, 0.98]

5 Complications of surgery and medical treatment Show forest plot	2	226	Risk Ratio (M‐H, Fixed, 95% CI)	1.38 [1.08, 1.76]

6 Improvement in neurophysiological parameters Show forest plot	1	50	Risk Ratio (M‐H, Fixed, 95% CI)	1.44 [1.05, 1.97]

6.1 Change in amplitude of sensory potential	1	50	Risk Ratio (M‐H, Fixed, 95% CI)	1.44 [1.05, 1.97]

Comparison 2. Surgical versus non‐surgical treatment ‐ secondary outcomes