Table 1.
Certainty assessment of evidence
| Certainty assessment | No of patients | Effect | Certainty | Importance | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| № of studies | Study design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | Intraosseous access | intravenous access | Relative (95% CI) | Absolute (95% CI) | ||
| Success rate on first attempt | ||||||||||||
| 5 | Randomized trials | Not serious | Serious | Not serious | Not serious | None | 168/185 (90.8%) | 141/232 (60.8%) | RR 1.48 (1.32 to 1.66) | 292 more per 1000 (from 194 to 401 more) | ⨁⨁⨁◯ Moderate | CRITICAL |
| Mean time to resuscitation | ||||||||||||
| 4 | Randomized trials | Not serious | Serious | Not serious | Not serious | None | 239 | 253 | – | MD 1.26 lower (1.57 lower to 0.94 lower) | ⨁⨁⨁◯ Moderate | IMPORTANT |
| Mean procedure time | ||||||||||||
| 5 | Randomized trials | Not serious | Serious | Not serious | Not serious | None | 279 | 293 | – | MD 2.58 lower (2.78 lower to 2.37 lower) | ⨁⨁⨁◯ Moderate | IMPORTANT |
| Complications | ||||||||||||
| 4 | Randomized trials | Serious | Serious | Not serious | Not serious | All plausible residual confounding would reduce the demonstrated effect | 23/139 (16.5%) | 34/186 (18.3%) | RR 0.97 (0.61 to 1.55) | 5 fewer per 1,000 (from 71 fewer to 101 more) | ⨁⨁⨁◯ Moderate | IMPORTANT |
CI Confidence interval, MD mean difference, RR Risk ratio