Summary of findings 4. Individual tailored compared to continuous tapered dexamethasone regimen for prevention of bronchopulmonary dysplasia in preterm infants.
| Individual tailored compared to continuous tapered dexamethasone regimen for prevention of bronchopulmonary dysplasia in preterm infants | ||||||
| Patient or population: preterm infants at risk for bronchopulmonary dysplasia Intervention: individual tailored dexamethasone regimen Comparison: continuous tapered dexamethasone regimen | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with continuous tapered dexamethasone regimen | Risk with individual tailored | |||||
| Death or bronchopulmonary dysplasia at 36 weeks PMA | Study population | RR 1.06 (0.88 to 1.29) | 168 (3 RCTs) | ⊕⊕⊝⊝ LOWa,b | ||
| 639 per 1000 | 677 per 1000 (562 to 824) | |||||
| Death or cerebral palsy at 1 to 3 years | Study population | RR 7.24 (0.95 to 55.26) | 59 (1 RCT) | ⊕⊕⊕⊝ MODERATEb | ||
| 33 per 1000 | 241 per 1000 (32 to 1000) | |||||
| Death or abnormal neurodevelopmental outcome (various definitions) | Study population | RR 1.44 (0.99 to 2.07) | 168 (3 RCTs) | ⊕⊕⊝⊝ LOWa,b | ||
| 313 per 1000 | 451 per 1000 (310 to 648) | |||||
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; PMA: postmenstrual age; RR: risk ratio | ||||||
| GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect | ||||||
a Downgraded one level for serious study design limitations (unclear methodology or random sequence allocation, lack of blinding of clinicians and outcome assessment (Bloomfield 1998; Odd 2004 ) b Downgraded one level for serious imprecision of effect estimate (95% CI around estimate consistent with substatial harm or benefit and number of events < 300).