Summary of findings for the main comparison. IV + inhaled beta agonist compared with inhaled beta‐agonist for acute asthma.
| IV + inhaled beta agonist compared to inhaled beta‐agonist for acute asthma | ||||||
| Patient or population: patients with acute asthma Settings: ED and ICU Intervention: IV + inhaled beta agonist Comparison: inhaled beta‐agonist | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| inhaled beta‐agonist | IV + inhaled beta agonist | |||||
| Admissions to hospital | 54 per 100 | 25 per 100 (7 to 62) | OR 0.29 (0.06 to 1.38) | 29 (1 study) | ⊕⊕⊝⊝ low1 | |
| Length of stay in emergency department | mean control group stay was 57 (SD 56) minutes | The mean length of stay in the intervention groups was 12.95 minutes lower (38.74 lower to 12.84 higher) | MD ‐12.95 (‐38.74 to 12.84) | 46 (1 study) | ⊕⊕⊕⊝ moderate2 | |
| Pulse rate at 2 hours | the mean heart rate in the control group was 142 (SD 10) | The mean heart rate at 2 hours in the intervention groups was 10 beats per minute higher (1.07 lower to 21.07 higher) | MD 10.00 (‐1.07 to 21.07) | 29 (1 study) | ⊕⊕⊕⊝ moderate2 | |
|
Clinical Failure (children with a severe to moderate overall clinical assessment score at two hours) |
93 per 100 | 56 per 100 (22 to 84) | OR 0.09 (0.02 to 0.38) | 29 (1 study) | ⊕⊕⊕⊝ moderate2 | |
| *The basis for the assumed risk (e.g. the 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; OR: Odds 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 Admissions: one point deducted for risk of bias due to lack of clarity in randomisation and blinding procedures, and an additional point deducted as data contributed by only one study
2 An additional point deducted as data contributed by only one study