Table.
GRADE evaluation of interventions for head lice
| Important outcomes | Clearance of infestation, adverse effects | ||||||||
| Number of studies (participants) | Outcome | Comparison | Type of evidence | Quality | Consistency | Directness | Effect size | GRADE | Comment |
| What are the effects of treatments for head lice? | |||||||||
| 1 (193) | Eradication rate | Malathion v phenothrin | 4 | –1 | 0 | –1 | 0 | Low | Quality point deducted for sparse data. Directness point deducted for uncertainty about interventions |
| 1 (66) | Eradication rate | Malathion v permethrin | 4 | –1 | –1 | -1 | 0 | Very Low | Quality point deducted for sparse data. Consistency point deducted for different results at different end points. Directness point deducted for differences of intervention |
| 2 (205) | Eradication rate | Malathion v mechanical removal ("bug busting") | 4 | –1 | –1 | –1 | 0 | Very low | Quality point deducted for sparse data. Consistency point deducted for conflicting results. Directness point deducted for second RCT including different interventions and non-standard dose. |
| 1(73) | Eradication rate | Malathion v dimeticone | 4 | –1 | 0 | –1 | 0 | Low | Quality point deducted for sparse data. Directness point deducted for uncertain generalisability |
| 7 (726) | Eradication rate | Permethrin v lindane | 4 | 0 | 0 | 0 | 0 | High | |
| 1 (133) | Eradication rate | Permethrin v mechanical removal ("bug busting") | 4 | –1 | 0 | –1 | 0 | Low | Quality point deducted for sparse data. Directness point deducted for inclusion of other intervention and non-standard doses |
| 1 (115) | Eradication rate | TMP-SMX v permethrin | 4 | –2 | 0 | –1 | 0 | Very low | Quality points deducted for sparse data and poor quality of follow-up. Directness point deducted for inclusion of other intervention, non-identical comparators, and non-standard doses |
| 1 (115) | Eradication rate | TMP-SMX plus permethrin v permethrin alone | 4 | –2 | 0 | –1 | 0 | Very low | Quality points deducted for sparse data and poor quality of follow-up. Directness point deducted for inclusion of other intervention, non-identical comparators, and non-standard doses |
| 1 (143) | Eradication rate | Combined insecticides v herbal oils | 4 | –2 | 0 | –1 | 0 | Very low | Quality points deducted for sparse data and failure to explain high withdrawal rate. Directness point deducted for uncertain generalisability of herbal product outcome |
| 1 (253) | Eradication rate | Dimeticone v phenothrin | 4 | 0 | 0 | –1 | 0 | Moderate | Directness point deducted for uncertain generalisability of intervention |
| 1 (73) | Eradication rate | Dimeticone v malathion | 4 | –1 | 0 | –1 | 0 | Low | Quality point deducted for sparse data. Directness point deducted for uncertain generalisability |
| 1 (30) | Eradication rate | Mechanical removal ("bug busting") v phenothrin | 4 | –2 | 0 | –1 | 0 | Very low | Quality points deducted for sparse data and different follow-up for different groups. Directness point deducted for uncertain generalisability of intervention |
| 1 (95) | Eradication rate | Permethrin plus combing v permethrin alone | 4 | –1 | 0 | –1 | 0 | Low | Quality point deducted for sparse data. Directness point deducted for uncertain generalisability |
Type of evidence: 4 = RCT; 2 = Observational; 1 = Non-analytical/expert opinion. Consistency: similarity of results across studies. Directness: generalisability of population or outcomes.Effect size: based on relative risk or odds ratio.