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. 2023 Apr 5;2023(4):CD015016. doi: 10.1002/14651858.CD015016.pub3

Summary of findings 2. 'As needed' administration (e.g. based on pain scales) versus 'as scheduled' administration (e.g. a predefined time interval).

'As needed' administration (e.g. based on pain scales) versus 'as scheduled' administration (e.g. a predefined time interval)
Patient or population: postoperative pain in neonates
Setting: neonatal intensive care units
Intervention: 'as needed' administration (e.g. based on pain scales)
Comparison: 'as scheduled' administration (e.g. a predefined time interval)
Outcomes Anticipated absolute effects* (95% CI) Relative effect
(95% CI) № of participants
(studies) Certainty of the evidence
(GRADE) Comments
Risk with 'as scheduled' administration Risk with 'as needed' administration
Pain assessed with any of the prespecified scales, during the administration of selected drugs (neonates from 0 to 4 weeks) This outcome was not reported.
All‐cause mortality during initial hospitalization ‐ not reported This outcome was not reported.
Major neurodevelopmental disability in children aged 18 to 24 months or three to five years old ‐ not reported This outcome was not reported.
Cognitive and educational outcomes in children more than five years old ‐ not reported This outcome was not reported.
Severe (defined as stage 3 or greater) retinopathy of prematurity ‐ not reported This outcome was not reported.
Severe (grade 3 or greater) intraventricular hemorrhage (IVH) on cranial ultrasound ‐ not reported This outcome was not reported.
*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; OR: odds ratio; RR: risk ratio;
GRADE Working Group grades of evidenceHigh 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.

IVH: intraventricular hemorrhage