Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

265 questions · 280 findings · 26 reviews

No studies found 68 · 24.3%GRADE not reported 18 · 6.4%Very low 79 · 28.2%Low 57 · 20.4%Moderate 42 · 15%High 16 · 5.7%

Femoral vs subclavian insertion: short‐term catheterization

Immediate mechanical complications ‐ Total mechanical complications · critically ill patients

Femoral showed no clear difference in immediate mechanical complications ‐ Total mechanical complications compared with subclavian insertion: short‐term catheterization (high certainty).

1 finding from 1 review

Femoral vs subclavian insertion: short‐term catheterization

Immediate mechanical complications ‐ Major mechanical complications · critically ill patients

Femoral showed no clear difference in immediate mechanical complications ‐ Major mechanical complications compared with subclavian insertion: short‐term catheterization (high certainty).

1 finding from 1 review

Femoral vs internal jugular insertion: short‐term catheterization

Catheter‐related infectious complications ‐ Catheter colonization · critically ill patients who were expected to require support with renal replacement therapy

Femoral showed no clear difference in catheter‐related infectious complications ‐ Catheter colonization compared with internal jugular insertion: short‐term catheterization (moderate certainty).

1 finding from 1 review

Femoral vs internal jugular insertion: short‐term catheterization

Catheter‐related blood stream infection · critically ill patients who were expected to require support with renal replacement therapy

Femoral showed no clear difference in catheter‐related infectious complications ‐ Catheter related… compared with internal jugular insertion: short‐term catheterization (moderate certainty).

1 finding from 1 review

Femoral vs internal jugular insertion: short‐term catheterization

Catheter‐related infectious complication ‐ Subgroup Analysis for the effect of BMI on catheter colonization ‐ Highest BMI tercile (>28.4) · critically ill patients who were expected to require support with renal replacement therapy

Femoral probably leads to higher catheter‐related infectious complication ‐ Subgroup Analysis for the… compared with internal jugular insertion: short‐term catheterization (moderate certainty).

1 finding from 1 review

Femoral vs internal jugular insertion: short‐term catheterization

Catheter‐related thrombotic complications ‐ Symptomatic deep venous thrombosis · critically ill patients who were expected to require support with renal replacement therapy

Femoral showed no clear difference in catheter‐related thrombotic complications ‐ Symptomatic deep venous… compared with internal jugular insertion: short‐term catheterization (moderate certainty).

1 finding from 1 review

Femoral vs internal jugular insertion: short‐term catheterization

Catheter‐related thrombosis at any time during catheter stay · critically ill patients who were expected to require support with renal replacement therapy

Femoral showed no clear difference in catheter‐related thrombotic complications ‐ Catheter related… compared with internal jugular insertion: short‐term catheterization (moderate certainty).

1 finding from 1 review

Femoral vs internal jugular insertion: short‐term catheterization

Immediate mechanical complications ‐ Total mechanical complications · critically ill patients who were expected to require support with renal replacement therapy

Femoral probably leads to lower immediate mechanical complications ‐ Total mechanical complications compared with internal jugular insertion: short‐term catheterization (moderate certainty).

1 finding from 1 review

Femoral vs internal jugular insertion: short‐term catheterization

Immediate mechanical complications ‐ Major mechanical complications · critically ill patients who were expected to require support with renal replacement therapy

Femoral showed no clear difference in immediate mechanical complications ‐ Major mechanical complications compared with internal jugular insertion: short‐term catheterization (moderate certainty).

1 finding from 1 review

Femoral vs subclavian insertion: short‐term catheterization

Catheter‐related infectious complications ‐ Catheter colonization · critically ill patients

Femoral leads to higher catheter‐related infectious complications ‐ Catheter colonization compared with subclavian insertion: short‐term catheterization (high certainty).

1 finding from 1 review

Femoral vs subclavian insertion: short‐term catheterization

Catheter‐related blood stream infection · critically ill patients

Femoral showed no clear difference in catheter‐related infectious complications ‐ Catheter‐related… compared with subclavian insertion: short‐term catheterization (high certainty).

1 finding from 1 review

Neuromuscular electrical stimulation + other intervention (e.g. exercise) vs other intervention alone

Kujala patellofemoral disorders score Scale from: 0 to 100 (higher scores = better function) · patients with patellofemoral pain syndrome (symptoms > 4 weeks (1 study); symptoms > 6 weeks (1 study); symptoms > 8 weeks (1 study); not…
1 finding from 1 review

Higher drinking-water fluoride exposure vs Null / lowest drinking-water fluoride exposure (reference)

Risk of femoral fractures · general population

Femoral-fracture risk was mildly U-shaped: RR 0.86 at 0.5 mg/L rising to 1.06 at 1.8 mg/L drinking-water fluoride vs null; risk mostly below null across the range; ungraded.

2 findings from 1 review
  • The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomes
    Long-term / lifetime fluoride exposure · General population; 37 observational studies (1944-2024), predominantly North America (USA, Canada) and Northern Europe (Finland, Sweden), plus UK, Poland, Italy, Germany, China, Taiwan, South Korea, Ethiopia; exposure mainly community drinking-water fluoride · Drinking-water fluoride 1.8 mg/L vs null
    RR 1.06 [0.67, 1.69]
    Studies not reported
    GRADE not reported
  • The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomes
    Long-term / lifetime fluoride exposure · General population; 37 observational studies (1944-2024), predominantly North America (USA, Canada) and Northern Europe (Finland, Sweden), plus UK, Poland, Italy, Germany, China, Taiwan, South Korea, Ethiopia; exposure mainly community drinking-water fluoride · Drinking-water fluoride 0.5 mg/L vs null
    RR 0.86 [0.71, 1.05]
    Studies not reported
    GRADE not reported

Genetically predicted periodontitis vs Lower genetically predicted periodontitis liability

Femoral neck bone mineral density (FN-BMD) · European-ancestry adults

Genetically predicted periodontitis had no causal effect on femoral neck BMD.

1 finding from 1 review

Genetically predicted DMFS (dental caries) vs Reference (1-SD lower genetically predicted DMFS)

Femoral neck bone mineral density (FN-BMD) · European-ancestry adults

Genetically predicted dental caries (DMFS) had no causal effect on femoral neck BMD.

1 finding from 1 review

Higher drinking-water fluoride exposure vs Null / lowest drinking-water fluoride exposure (reference)

Hip/femoral bone mineral density (BMD) · general population

Hip BMD increased with fluoride in both sexes (linearly in males, non-linearly above ~1.2 mg/L in females); no numeric MD reported in text for the main analysis; ungraded.

1 finding from 1 review
  • The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomes
    Long-term / lifetime fluoride exposure · General population; 37 observational studies (1944-2024), predominantly North America (USA, Canada) and Northern Europe (Finland, Sweden), plus UK, Poland, Italy, Germany, China, Taiwan, South Korea, Ethiopia; exposure mainly community drinking-water fluoride · Both sexes, main dose-response
    Hip BMD increased in both sexes, linearly in males and non-linearly (starting above 1.2 mg/L) in females (no numeric MD reported in text for main analysis)
    Studies not reported
    GRADE not reported

Higher drinking-water fluoride exposure vs Null / lowest drinking-water fluoride exposure (reference)

Hip/femoral bone mineral density (BMD) · Females (all ages)

In females (low-to-moderate risk-of-bias studies), hip BMD rose monotonically above ~0.9 mg/L: MD 0.04 g/cm2 (95% CI -0.03-0.12) up to ~2.3 mg/L and 0.09 (-0.09-0.27) at 4.0 mg/L vs null; ungraded.

2 findings from 1 review
  • The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomes
    Long-term / lifetime fluoride exposure · General population; 37 observational studies (1944-2024), predominantly North America (USA, Canada) and Northern Europe (Finland, Sweden), plus UK, Poland, Italy, Germany, China, Taiwan, South Korea, Ethiopia; exposure mainly community drinking-water fluoride · Females, low-to-moderate risk-of-bias studies: up to ~2.3 mg/L vs null
    MD 0.04 [-0.03, 0.12]
    Studies not reported
    GRADE not reported
  • The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomes
    Long-term / lifetime fluoride exposure · General population; 37 observational studies (1944-2024), predominantly North America (USA, Canada) and Northern Europe (Finland, Sweden), plus UK, Poland, Italy, Germany, China, Taiwan, South Korea, Ethiopia; exposure mainly community drinking-water fluoride · Females, low-to-moderate risk-of-bias studies: 4.0 mg/L vs null
    MD 0.09 [-0.09, 0.27]
    Studies not reported
    GRADE not reported

Surgical vs non‐surgical treatment

Kujala patellofemoral disorders score Scale from: 0 to 100 (higher scores = better function) · people with lateral patellar dislocation

It is very uncertain whether surgical changes knee and physical functiona Measured using the Kujala patellofemoral… compared with non‐surgical treatment (very low certainty).

1 finding from 1 review