Table 2 Quality assessment of trials of antiemetics on vomiting and hospitalization rates in acute gastroenteritis
From: The effect of antiemetics in childhood gastroenteritis
Quality Assessment | Summary of Findings | |||||||
|---|---|---|---|---|---|---|---|---|
| 听 | Directness | No of events | 听 | |||||
No of studies | Design | Limitations | Consistency | Generalizability to population of interest | Generalizability to intervention of interest | Intervention | Control | Relative Risk (95% CI) |
Morbidity-Vomiting: Moderate outcome-specific quality | ||||||||
RCT | Studies used different follow up periods. Random effect model was used | All studies suggest benefit | Four of six studies were conducted in developed countries | Pooled results for different types of antiemetics and route of administration. | 95 | 210 | 0.46 [0.35, 0.61] b | |
RCT | 听 | All studies suggest benefit | Three of four studies were conducted in developed countries | Effect of oral ondansetron | 47 | 134 | 0.35 (0.26, 0.46) a | |
1 [12] | RCT | Insignificant effect | 听 | In developing country | Effect of IV ondansetron | 5 | 10 | 0.50 (0.24, 1.04) |
1 [12] | RCT | Insignificant effect | 听 | In developing country | Effect of IV metoclopramide | 8 | 10 | 0.80 (0.50, 1.28) |
1 [19] | RCT | 听 | 听 | In developed country | Effect of rectal dimenhydrinate | 35 | 56 | 0.60 (0.44, 0.82) |
Morbidity- Hospitalization rates: Moderate outcome-specific quality | ||||||||
RCT | 听 | All studies suggest benefit. Fixed effect model used | Five of six studies were conducted in developed countries | Pooled results for different types of antiemetics and route of administration. | 24 | 56 | 0.46 [0.29, 0.74] a | |
RCT | 听 | All studies suggest benefit | Three of four studies were conducted in developed countries | Effect of oral ondansetron | 11 | 33 | 0.36 (0.18, 0.72) a | |
1 [20] | RCT | 听 | 听 | Developed country | Effect of IV ondansetron | 2 | 9 | 0.21 (0.05, 0.94) |
1 [20] | RCT | Insignificant effect | 听 | Developed country | Effect of IV dexamethasone | 7 | 9 | 0.73 (0.30, 1.79) |
1 [19] | RCT | Insignificant effect | 听 | Developed country | Effect of rectal dimenhydrinate | 4 | 5 | 0.77 (0.21, 2.78) |
Revisit rates : low outcome-specific quality | ||||||||
RCT | Variable time periods used in the four studies | Two studies suggest benefit while two studies report otherwise | Three out of four studies were conducted in developed countries | All studies used oral ondasetron | 34/284 | 30/269 | 0.97 [0.62, 1.53] a | |
IVF required rates: Low outcome-specific quality | ||||||||
RCT | 听 | All studies are consistent in the results. Fixed effect model used | All studies were conducted in developed countries | All studies used oral ondansetron | 35 | 93 | 0.40 [0.29, 0.56] a | |
ORT tolerance rates: Low outcome specific quality | ||||||||
RCT | 听 | Random effect model used. Two of the three studies suggest benefit | All studies were conducted in developed countries | Pooled results for different antiemetics and routes of administrations | 155 | 125 | 1.22 [1.01, 1.46] b | |
Admission Rates within 72 hours of discharge from ED: Low outcome-specific quality | ||||||||
RCT | 听 | All studies suggest benefit | All studies were conducted in developed countries | All studies used oral ondansetron | 18 | 30 | 0.66 [0.37, 1.19] | |
IVF requirement Rates within 72 hours of discharge from ED oral ondansetron: low outcome-specific quality | ||||||||
RCT | 听 | Consistent benefit suggested by the three studies | All studies were conducted in developed countries | All studies used oral ondansetron | 49 | 86 | 0.57 [0.42, 0.76] a | |