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What do systematic reviews say?

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Evidence found and GRADE certainty

199 questions · 199 findings · 17 reviews · Metabolic and Endocrine Disorders

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No studies found 90 · 45.2%GRADE not reported 5 · 2.5%Very low 43 · 21.6%Low 37 · 18.6%Moderate 22 · 11.1%High 2 · 1%

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 Pharmacological therapy

Health‐related quality of life Mean AcroQoL score (0‐100) · adults with growth‐hormone secreting pituitary adenomas

Surgery alone showed no clear difference in health‐related quality of life Mean AcroQoL score (0‐100) compared with pharmacological therapy alone (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