Table 3.
The GRADE assessment.
| Patient or population: Patients with confirmed or suspected necrotizing enterocolitis | ||||||
|---|---|---|---|---|---|---|
| Settings: Neonatology | ||||||
| Intervention: Ultrasound | ||||||
| Comparison: Abdominal Radiography | ||||||
| Outcomes | Illustrative comparative risksa (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Radiography | Ultrasound | |||||
| Portal venous gas | 76 per 1,000 | 160 per 1,000 (100 to 247) | OR 2.31 (1.35 to 3.99) | 2,702 (18 studies) | ⊕⊝⊝⊝ very lowb,c,d | |
| Pneumatosis | 340 per 1,000 | 384 per 1,000 (297 to 481) | OR 1.21 (0.82 to 1.80) | 2,750 (19 studies) | ⊕⊝⊝⊝ very lowe,d,f | |
| Pneumoperitoneum | 112 per 1,000 | 72 per 1,000 (38 to 137) | OR 0.62 (0.31 to 1.26) | 2,512 (15 studies) | ⊕⊝⊝⊝ very lowe,e,f | |
| Intestinal dilatation | 317 per 1,000 | 191 per 1,000 (81 to 393) | OR 0.51 (0.19 to 1.40) | 1,667 (11 studies) | ⊕⊝⊝⊝ very lowe,g,f,h | |
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.
Moderate heterogeneity.
RR > 2.0.
Most studies used paired designs but only reported independent rates; not analyzed using paired methods. 95% confidence interval (CI) may be too narrow.
High heterogeneity.
95% CI crosses the null value (OR=1.0).
Paired data not analyzed using paired methods may narrow 95% CI.
RR = 0.74.