Figure 7

Manhattan-like three-dimensional matrix building upon the risks of systematic error, random error, and design error. The evidence with the lowest systematic, random, and design error is represented by the tallest skyscrapers, located on 'the upper west side'. a. Outcomes with benefit of antiarrhythmics for maintaining sinus rhythm after cardioversion of atrial fibrillation. b. Outcomes with harm of antiarrhythmics for maintaining sinus rhythm after cardioversion of atrial fibrillation. A 'quick guide' to the perception of the figure: If you want to know what the evidence is for antiarrhythmics for maintaining sinus rhythm after cardioversion of atrial fibrillation to influence all-cause mortality: go to the red bars and read 1) Level of evidence (the risk of systematic error) and 2) standard error (the risk of random error). Only the Cochrane review and the trials included in this systematic review were considered in this example. Data with risk of random error SE >1.0 were omitted from the figure. The SE of outcomes with zero events cannot be calculated. From these 'benefit' and 'harm' Manhattan figures, one can see at a glance that there is no benefit at all and that 'the upper west side' is empty. Class 1a antiarrhythmics might increase mortality; however, since high risks for both systematic error and random error are present there is insufficient evidence for reliable conclusions.