Summary of findings for the main comparison. Haloperidol versus first‐generation antipsychotics for schizophrenia (short term).
| Haloperidol versus first‐generation antipsychotics for schizophrenia | ||||||
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Patient or population: people with schizophrenia Setting: inpatients and outpatients Intervention: haloperidol versus other first‐generation antipsychotics (short term) | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| first‐generation antipsychotic drugs | haloperidol | |||||
| Clinically important response to treatment (short term) | Study population | RR 0.93 (0.87 to 1) | 2132 (40 studies) | ⊕⊕⊝⊝ low1,2 | ||
| 457 per 1000 | 425 per 1000 (398 to 457) | |||||
| Moderate | ||||||
| 532 per 1000 | 495 per 1000 (463 to 532) | |||||
| Leaving the study early due to any reason as a measure of overall acceptability (short term) | Study population | RR 1.04 (0.87 to 1.24) | 1299 (28 studies) | ⊕⊕⊝⊝ low1,2,3 | ||
| 201 per 1000 | 209 per 1000 (175 to 250) | |||||
| Moderate | ||||||
| 142 per 1000 | 148 per 1000 (124 to 176) | |||||
| Leaving the study early due to inefficacy of treatment as a measure of overall efficacy (short term) | Study population | RR 0.93 (0.4 to 2.16) | 507 (13 studies) | ⊕⊝⊝⊝ very low1,2,3,4 | ||
| 43 per 1000 | 40 per 1000 (17 to 94) | |||||
| Moderate | ||||||
| 0 per 1000 | 0 per 1000 (0 to 0) | |||||
| Leaving the study early due to adverse events as a measure of overall tolerability (short term) | Study population | RR 1 (0.42 to 2.35) | 640 (16 studies) | ⊕⊝⊝⊝ very low1,2,3,4 | ||
| 31 per 1000 | 31 per 1000 (13 to 73) | |||||
| Moderate | ||||||
| 0 per 1000 | 0 per 1000 (0 to 0) | |||||
| Adverse effects: number of participants with at least one adverse effect (short term) | Study population | RR 1.06 (0.94 to 1.2) | 693 (10 studies) | ⊕⊕⊝⊝ low1,2,3 | ||
| 615 per 1000 | 652 per 1000 (578 to 738) | |||||
| Moderate | ||||||
| 588 per 1000 | 623 per 1000 (553 to 706) | |||||
| Adverse effects: extrapyramidal side effects: number of participants with at least one extrapyramidal side effect (short term) | Study population | RR 1.12 (0.95 to 1.31) | 998 (17 studies) | ⊕⊝⊝⊝ very low1,2,3,5 | ||
| 365 per 1000 | 409 per 1000 (347 to 479) | |||||
| Moderate | ||||||
| 410 per 1000 | 459 per 1000 (389 to 537) | |||||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes6. 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. | ||||||
1 Risk of bias ‐ rated 'very serious': many studies did not report the methods for sequence generation and/or allocation concealment and were not free from selective reporting. 2 Inconsistency ‐ rated 'no': there was no substantial level of heterogeneity (defined by an I2 greater than or equal to 50% accompanied by a statistically significant Chi2 test). The direction of the effect of almost all studies was the same. Therefore, the overall results are not challenged by inconsistency.
3Publication bias ‐ rated 'undetected': based on the largely symmetrical arrangement of the trials in the funnel plot the likelihood for the presence of a publication bias can be regarded as being low.
4 Imprecision ‐ rated 'very serious': the 95% confidence interval around the pooled effect size includes "no effect", "appreciable benefit", and "appreciable harm".
5 Imprecision ‐ rated 'serious': the 95% confidence interval around the pooled effect size includes both "no effect" and "appreciable harm". 6 The basis for the assumed risk was the risk in the pooled control group of the relevant studies.