Fig. 6

Trial sequential analysis of 7 trials comparing NOM vs. OM for treatment efficacy at 1-year follow-up. The cumulative Z-curve crossed the conventional boundary for benefit, the trial sequential monitoring boundary for benefit and required information size, suggesting that the current evidence is conclusive and further trials will not change this conclusion. A diversity adjusted required information size of 611 patients was calculated using an alpha = 0.05 (two sided) and a beta = 0.20 (power 80%), and empirical estimation from TSA software