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What do systematic reviews say?

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Evidence found and GRADE certainty

216 questions · 226 findings · 24 reviews · Metabolic and Endocrine Disorders

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No studies found 84 · 37.2%GRADE not reported 5 · 2.2%Very low 73 · 32.3%Low 39 · 17.3%Moderate 25 · 11.1%High 0 · 0%

Surgery vs preoperative pharmacological therapy and surgery

Adverse events · adults with growth‐hormone secreting pituitary adenomas

It is very uncertain whether surgery alone changes adverse events compared with preoperative pharmacological therapy and surgery (very low certainty).

1 finding from 1 review

Surgery vs preoperative pharmacological therapy and surgery

Surgery for recurrent or persistent disease · adults with growth‐hormone secreting pituitary adenomas

It is very uncertain whether surgery alone changes surgery for recurrent or persistent disease compared with preoperative pharmacological therapy and surgery (very low certainty).

1 finding from 1 review

Surgery vs preoperative pharmacological therapy and surgery

Non‐surgical therapy for recurrent or persistent diseaseRadiation therapy and/or pharmacologic therapy for recurrent or persistent disease · adults with growth‐hormone secreting pituitary adenomas

It is very uncertain whether surgery alone changes non‐surgical therapy for recurrent or persistent diseaseRadiation… compared with preoperative pharmacological therapy and surgery (very low certainty).

1 finding from 1 review

Surgery vs preoperative pharmacological therapy and surgery

Disease‐related complications Intubation difficulties requiring postponement of surgery · adults with growth‐hormone secreting pituitary adenomas

It is very uncertain whether surgery alone changes disease‐related complications Intubation difficulties requiring… compared with preoperative pharmacological therapy and surgery (very low certainty).

1 finding from 1 review

Minimally invasive parathyroidectomy vs bilateral neck exploration

Success rate (eucalcaemia) (a)

It is very uncertain whether minimally invasive parathyroidectomy changes success rate (eucalcaemia) (a) compared with bilateral neck exploration (very low certainty).

1 finding from 1 review

Minimally invasive parathyroidectomy vs bilateral neck exploration

Adverse effects: perioperative complications (number of events)

Minimally invasive parathyroidectomy may leads to lower total incidence of perioperative adverse events (number) compared with bilateral neck exploration (low certainty).

1 finding from 1 review