Summary of findings for the main comparison. Any antiglucocorticoid compared with placebo as sole treatment (data only for mifepristone) for psychosis.
| Any antiglucocorticoid compared with placebo as sole treatment (data only for mifepristone) for psychosis | ||||||
| Patient or population: people with psychosis Settings: inpatient/outpatient Intervention: any antiglucocorticoid Comparison: placebo as sole treatment (data only for mifepristone) | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | Number of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Placebo as sole treatment (data only for mifepristone) | Any antiglucocorticoid | |||||
| Mental state: 1. General ‐ average endpoint score BPRS total scores Follow‐up: 4 days | Mean mental state: 1. General ‐ average endpoint score in intervention groups was 5.2 lower (17.91 lower to 7.51 higher) | 5 (1 study) | ⊕⊝⊝⊝ Very lowa,b,c | |||
| Mental state: 2. Specific ‐ depression ‐ average endpoint score HAMD total Follow‐up: 4 days | Mean mental state: 2. Specific ‐ depression ‐ average endpoint score in intervention groups was 1.67 higher (16.44 lower to 19.78 higher) | 5 (1 study) | ⊕⊝⊝⊝ Very lowa,b,c | |||
| Global state: 1. General ‐ no clinically significant improvement ‐ short term < 30% improvement on BPRS Follow‐up: 7 days | Lowd | RR 0.58 (0.38 to 0.89) | 221 (1 study) | ⊕⊕⊝⊝ Lowe,f | ||
| 200 per 1000 | 116 per 1000 (76 to 178) | |||||
| Moderated | ||||||
| 400 per 1000 | 232 per 1000 (152 to 356) | |||||
| Highd | ||||||
| 600 per 1000 | 348 per 1000 (228 to 534) | |||||
| Global state: 2. Specific: positive ‐ no clinically significant improvement ‐ short term (< 50% improvement on BPRS PSS) Follow‐up: 7 days | Lowd | RR 0.6 (0.43 to 0.84) | 221 (1 study) | ⊕⊕⊝⊝ Lowe,f | ||
| 300 per 1000 | 180 per 1000 (129 to 252) | |||||
| Moderated | ||||||
| 500 per 1000 | 300 per 1000 (215 to 420) | |||||
| Highd | ||||||
| 700 per 1000 | 420 per 1000 (301 to 588) | |||||
| General functioning: improved to an important degree | See comment | See comment | Not estimable | 0 (0) | See comment | No study reported this outcome |
| Adverse effects: general: overall number of events Follow‐up: 7 days | Lowd | RR 0.92 (0.77 to 1.09) | 226 (2 studies) | ⊕⊕⊕⊝ Moderatee | ||
| 500 per 1000 | 460 per 1000 (385 to 545) | |||||
| Moderated | ||||||
| 700 per 1000 | 644 per 1000 (539 to 763) | |||||
| Highd | ||||||
| 900 per 1000 | 828 per 1000 (693 to 981) | |||||
| Quality of life: improved to an important degree | See comment | See comment | Not estimable | 0 (0) | See comment | No study reported this outcome |
| *The basis for the assumed risk (e.g. median control group risk across studies) is provided in footnotes. The corresponding risk (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; RR: Risk ratio. | ||||||
| GRADE Working Group grades of evidence. High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
aRisk of bias: rated 'serious' ‐ unclear how undertaken, groups imbalanced. bImprecision: rated 'serious' ‐ small study. cPublication bias: rated 'strongly suspected' ‐ one very small trial, may well be other unpublished work. dModerate risk roughly equal to that of people in control group of trial. eRisk of bias: rated 'serious' ‐ allocation concealment unclear, blinding untested, study authors allied with relevant company. fIndirectness: rated 'serious' ‐ BPRS not direct measure of global state.