Summary of findings 9. Summary of findings table ‐ Maintenance ASM versus no maintenance ASM after achieving seizure control in clinically diagnosed neonatal seizures.
| Maintenance ASM versus no maintenance ASM after achieving seizure control in clinically diagnosed neonatal seizures | ||||||
| Patient or population: neonates with clinically diagnosed seizures Setting: Neonatal intensive care unit Intervention: maintenance ASM after achieving seizure control Comparison: no maintenance ASM after achieving seizure control | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with no maintenance ASM after achieving seizure control | Risk with maintenance ASM after achieving seizure control | |||||
| Proportion of infants with repeat seizure before hospital discharge | 353 per 1000 | 268 per 1000 (198 to 356) | RR 0.76 (0.56 to 1.01) | 373 (2 RCTs) | ⊕⊝⊝⊝ Very lowa,b | |
| Mortality or neurodevelopmental disability at 18 to 24 months' corrected age ‐ not reported | ‐ | ‐ | ‐ | ‐ | ‐ | Neither of the two included studies reported this outcome. |
| Mortality before hospital discharge | 139 per 1000 | 96 per 1000 (54 to 170) | RR 0.69 (0.39 to 1.22) | 373 (2 RCTs) | ⊕⊕⊝⊝ Lowb | |
| Mortality at 18‐24 months | 121 per 1000 | 113 per 1000 (41 to 315) | RR 0.94 (0.34 to 2.61) | 111 (1 RCT) | ⊕⊕⊝⊝ Lowb | |
| Neurodevelopmental disability at 18‐24 months | 39 per 1000 | 35 per 1000 (5 to 240) | RR 0.89 (0.13 to 6.12) | 108 (1 RCT) | ⊕⊕⊝⊝ Lowb | |
| Proportion of infants who develop epilepsy post‐discharge | 33 per 1000 | 106 per 1000 (23 to 491) | RR 3.18 (0.69 to 14.72) | 126 (1 RCT) | ⊕⊕⊝⊝ Lowb | |
| *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; 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. | ||||||
| See interactive version of this table: https://gdt.gradepro.org/presentations/#/isof/isof_question_revman_web_438158727822576253. | ||||||
a Downgraded by one level for risk of bias due to 'some concerns' in the risk of bias in both the included studies b Downgraded by two levels for very serious imprecision due to very low sample size and event rate not meeting the 'Optimal Information Size' criteria