Summary of findings for the main comparison. Educational interventions for adults who attend the emergency room for acute asthma.
| Educational interventions for adults who attend the emergency room for acute asthma | ||||||
| Patient or population: Adults who attend the emergency room for acute asthma Settings: Community Intervention: Education | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Control | educational interventions | |||||
|
Hospital admission/re‐admission Follow‐up ‐ median: 24 weeks (range 4 to 78 weeks) |
Study population | RR 0.5 (0.27 to 0.91) | 572 (5 studies) | ⊕⊕⊕⊕ high | ||
| 259 per 1000 | 130 per 1000 (70 to 236) | |||||
| Medium risk population | ||||||
| 271 per 1000 | 136 per 1000 (73 to 247) | |||||
|
Presentation at emergency department Follow‐up ‐ median 24 weeks (range 8 to 78 weeks) |
Study population | RR 0.72; (0.47 to 1.11) | 946 (8 studies) | ⊕⊕⊝⊝ low1,2 | ||
| 244 per 1000 | 175 per 1000 (115 to 270) | |||||
| Medium risk population | ||||||
| 245 per 1000 | 176 per 1000 (115 to 272) | |||||
|
Quality of life (SGRQ) ‐ Total scores
SGRQ units. Scale from: 0 to 100. Follow‐up: mean 6 months |
The mean Quality of life (SGRQ) ‐ Total scores in the intervention groups was 2.17 lower (9.34 lower to 5 higher) | 356 (2 studies) | ⊕⊕⊝⊝ low3,4 | |||
| *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; 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 (‐1): The design of some of the studies put the results at some risk of bias. A sensitivity analysis which removed studies at a high risk of selection bias gave a result that was closer to unity. 2 Imprecision (‐1): The confidence interval around the pooled effect estimate is compatible with both a small increase and large reduction in the risk of ED re‐presentation.
3 Inconsistency (‐1): Only two studies contributed data and there was some discordance between their effect sizes on the total domain of the SGRQ (I square: 77%)). 4 Imprecision (‐1): The number of studies is low for this outcome and the pooled result requires replication.