TABLE 5.
Qualities of the evidence measuring major outcomes rated by the GRADE system.
| Reviews (year) | Outcome indiccator | Intervention measures (T/C) | Effect amount and 95%CI | Bias risk | Inconsistency | Indirectivity | Inaccuracy | Publication bias | Evidence quality | |
|---|---|---|---|---|---|---|---|---|---|---|
| Liu et al. (2022) | ① | Viable Clostridium butyricum and CWM | CWM | RR = 0.29, 95%CI [0.25, 0.34] | −1 | 0 | 0 | 0 | 0 | Moderate✱ |
| ③ | Viable Clostridium butyricum and CWM | CWM | MD = −1.87, 95%CI [-2.11, −1.6] | −1 | −1 | 0 | 0 | 0 | Low✱$ | |
| ⑤ | Viable Clostridium butyricum and CWM | CWM | MD = −1.96, 95%CI [-2.22, −1.70] | −1 | −1 | 0 | 0 | 0 | Low✱$ | |
| He et al. (2017) | ① | PP | Placebo | RR = 0.32, 95%CI [0.24, 0.40] | 0 | 0 | 0 | 0 | 0 | High |
| ⑥ | PP | Placebo | RR = 0.37, 95%CI [0.15, 0.91] | 0 | 0 | 0 | 0 | 0 | High | |
| ③ | PP | Placebo | MD = −1.77, 95%CI [-2.03, −1.51] | 0 | −1 | 0 | 0 | 0 | Moderate$ | |
| ⑦ | PP | Placebo | MD = −0.19, 95%CI [-0.38, −0.01] | 0 | −1 | 0 | 0 | 0 | Moderate$ | |
| Lu. (2010) | ④ | PP | CWM | OR = 0.22, 95%CI [0.15, 0.32] | 0 | 0 | 0 | 0 | 0 | High |
| Shi et al. (2006) | ① | PP | Blank | OR = 0.28, 95%CI [0.20, 0.38] | −1 | 0 | 0 | 0 | −1 | Low✱# |
| Chen et al. (2010) | ① | PP | Blank | RR = 0.36, 95%CI [0.27, 0.48] | 0 | 0 | 0 | 0 | −1 | Moderate# |
| Liu et al. (2020) | ④ | Bifidobacterium preparations and CWM | CWM | RR = 1.21, 95%CI [1.14, 1.27] | −1 | 0 | 0 | 0 | −1 | Low✱# |
| ③ | Bifidobacterium preparations and CWM | CWM | SMD = −0.80, 95%CI [-1.05, −0.55] | −1 | 0 | 0 | 0 | 0 | Moderate✱ | |
| ⑤ | Bifidobacterium preparations and CWM | CWM | SMD = −0.49, 95%CI [-0.73, −0.25] | −1 | 0 | 0 | 0 | 0 | Moderate✱ | |
| Chai et al. (2017) | ④ | Bifidobacterium tetravaccine tablets | CWM | OR = 5.74, 95%CI [4.14, 7.96] | 0 | 0 | 0 | 0 | −1 | Moderate# |
| You and Gao. (2015) | ① | Live combined Bacillus subtilis and CWM | CWM | OR = 0.27, 95%CI [0.22, 0.32] | −1 | 0 | 0 | 0 | 0 | Moderate✱ |
| ④ | Live combined Bacillus subtilis and CWM | CWM | OR = 6.76, 95%CI [4.16, 10.98] | −1 | 0 | 0 | 0 | 0 | Moderate✱ | |
| Yang et al. (2016a) | ① | Saccharomyces boulardii sachets and CWM | CWM | RR = 0.47, 95%CI [0.42, 0.53] | −1 | 0 | 0 | 0 | −1 | Low✱# |
| ④ | Saccharomyces boulardii sachets and CWM | CWM | RR = 1.34, 95%CI [1.22, 1.47] | −1 | 0 | 0 | 0 | 0 | Moderate✱ | |
| ③ | Saccharomyces boulardii sachets and CWM | CWM | MD = −1.82, 95%CI [-2.15, −1.48] | −1 | −1 | 0 | 0 | −1 | Critically low✱$# | |
| ⑨ | Saccharomyces boulardii sachets and CWM | CWM | MD = −1.60, 95%CI [-1.71, −1.48] | −1 | 0 | 0 | 0 | 0 | Moderate✱ | |
| ⑤ | Saccharomyces boulardii sachets and CWM | CWM | MD = −2.47, 95%CI [-2.65, −2.29] | −1 | 0 | 0 | 0 | 0 | Moderate✱ | |
| Yang et al. (2016a) | ④ | Saccharomyces boulardii sachets and CWM | CWM | RR = 1.21, 95%CI [1.08, 1.35] | −1 | 0 | 0 | 0 | 0 | Moderate✱ |
| ⑧ | Saccharomyces boulardii sachets and CWM | CWM | RR = 1.81, 95%CI [1.48, 2.20] | −1 | 0 | 0 | 0 | −1 | Low✱# | |
| ③ | Saccharomyces boulardii sachets and CWM | CWM | MD = −1.95, 95%CI [-2.56, −1.34] | −1 | −1 | 0 | 0 | 0 | Low✱$ | |
| Zhou et al. (2016) | ① | Saccharomyces boulardii sachets and CWM | CWM | RR = 0.54, 95%CI [0.47, 0.61] | −1 | 0 | 0 | 0 | −1 | Low✱# |
| ④ | Saccharomyces boulardii sachets and CWM | CWM | RR = 1.41, 95%CI [1.28, 1.56] | −1 | 0 | 0 | 0 | 0 | Moderate✱ | |
| ③ | Saccharomyces boulardii sachets and CWM | CWM | SMD = −1.17, 95%CI [-1.48, −0.87] | −1 | −1 | 0 | 0 | 0 | Low✱$ | |
| ⑤ | Saccharomyces boulardii sachets and CWM | CWM | SMD = −2.32, 95%CI [-4.05, −0.60] | −1 | −1 | 0 | 0 | 0 | Low✱$ | |
| Chai et al. (2015) | ① | Saccharomyces boulardii sachets and CWM | CWM | OR = 0.32, 95%CI [0.27, 0.39] | −1 | 0 | 0 | 0 | −1 | Low✱# |
| Fang et al. (2013) | ① | Saccharomyces boulardii sachets and CWM | CWM | RR = 0.49, 95%CI [0.41, 0.58] | −1 | 0 | 0 | 0 | −1 | Low✱# |
| Xu et al. (2017) | ① | Saccharomyces boulardii sachets | Blank | OR = 0.33, 95%CI [0.29, 0.39] | −1 | −1 | 0 | 0 | 0 | Low✱$ |
| Szajewska et al. (2016) | ① | Saccharomyces boulardii sachets | Blank | OR = 0.48, 95%CI [0.37, 0.61] | −1 | 0 | 0 | 0 | −1 | Low✱# |
| ⑥ | Bifidobacterium preparations | Blank | RR = 0.34, 95%CI [0.15, 0.76] | −1 | 0 | 0 | 0 | 0 | Moderate✱ | |
| Szajewska et al. (2006) | ① | PP | Placebo | RR = 0.44, 95%CI [0.25, 0.77] | −1 | −1 | 0 | 0 | −1 | Critically low✱$# |
| ⑥ | PP | Placebo | RR = 0.38, 95%CI [0.12, 1.18] | 0 | 0 | 0 | 0 | −1 | Moderate# | |
| Johnston et al. (2011) | ① | PP | Placebo | RR = 0.52, 95%CI [0.38, 0.72] | −1 | −1 | 0 | 0 | 0 | Low✱$ |
| ③ | PP | Placebo | MD = −0.60, 95%CI [-1.18, −0.02] | −1 | −1 | 0 | 0 | 0 | Low✱$ | |
| ⑦ | PP | Placebo | MD = −0.30, 95%CI [-0.60, −0.00] | −1 | −1 | 0 | 0 | 0 | Low✱$ | |
| ② | PP | Placebo | RD = 0.00, 95%CI [-0.01, 0.02] | −1 | −1 | 0 | 0 | −1 | Critically low✱$# | |
| Johnston et al. (2006) | ① | PP | Placebo | RR = 0.43, 95%CI [0.25, 0.75] | −1 | −1 | 0 | 0 | 0 | Low✱$ |
| Goldenberg et al. (2015) | ① | PP | Placebo | RR = 0.46, 95%CI [0.35, 0.61] | −1 | −1 | 0 | 0 | 0 | Low✱$ |
| ③ | PP | Placebo | MD = −0.60, 95%CI [-1.18, −0.02] | −1 | −1 | 0 | 0 | 0 | Low✱$ | |
| ⑦ | PP | Placebo | MD = −0.30, 95%CI [-0.60, 0.00] | −1 | −1 | 0 | 0 | 0 | Low✱$ | |
| ② | PP | Placebo | RD = 0.00, 95%CI [-0.01, 0.01] | −1 | 0 | 0 | 0 | −1 | Low✱# | |
| Guo et al. (2019) | ① | PP | Placebo | RR = 0.459, 95%CII [0.36, 0.56] | −1 | −1 | 0 | 0 | 0 | Low✱$ |
| ③ | PP | Placebo | MD = −0.91, 95%CI [-1.38, −0.44] | −1 | −1 | 0 | 0 | 0 | Low✱$ | |
| ② | PP | Placebo | RD = 0.00, 95%CI [-0.01, 0.01] | −1 | −1 | 0 | 0 | −1 | Critically low✱$# | |
C, treatment group; T, control group; PP, probiotic preparations; CWM, conventional western medicine treatment.
Outcomes: ① incidence of AAD; ② adverse effects; ③ duration of diarrhea; ④ total effective rate; ⑤ mean hospital stay; ⑥ incidence of CDAD; ⑦ mean stool frequency; ⑧ cure rate; ⑨ antidiarrheal time.
OR, ratio; RR, relative risk; MD, weighted mean difference; SMD, standardized mean difference; RD, risk difference; −1: downgrade one level; 0: no downgrade; ✱: greater risk of bias in randomization, allocation concealment, and blinding; $: greater heterogeneity in combined results, I2 > 50%; #: potential for large publication bias.