Table 3.
GRADE evidence profile: antibiotic therapy versus appendicectomy for acute non‐perforated appendicitis
| No. of patients with data* Time frame | Quality assessment | Summary of findings | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Study event rates | Absolute risk difference† | Certainty in estimates | ||||||||
| Risk of bias | Inconsistency | Indirectness | Imprecision | Publication bias | Antibiotic therapy | Appendicectomy | ||||
| Major complications | ||||||||||
|
999 (5) 1 year |
Serious limitations: major and minor complications likely under‐reported in antibiotics group | No serious limitations | No serious limitations | Serious limitations: 95% confidence interval crosses 0, indicating no difference | Undetected | 25 of 510 (4·9) | 41 of 489 (8·4) |
−2·6 (−6·3, 1·1)% Favours antibiotic therapy |
Low | |
| Minor complications | ||||||||||
|
999 (5) 1 year |
Serious limitations: major and minor complications likely under‐reported in antibiotics group | Serious limitations: inconsistent forest plot estimates | No serious limitations | Serious limitations: 95% confidence interval crosses 0, indicating no difference | Undetected | 11 of 510 (2·2) | 61 of 489 (12·5) |
−7·2 (−18·1, 3·8)% Favours antibiotic therapy |
Very low | |
| Recurrence of appendicitis | ||||||||||
|
999 (5) 1 year |
No serious limitations | No serious limitations | No serious limitations | No serious limitations | Undetected | 114 of 510 (22·4) |
0 of 489 (0) |
22·6 (15·6 to 30·4)% Favours appendicectomy |
High | |
| Rate of appendicectomy within 1 month | ||||||||||
|
1112 (5) 1 month |
No serious limitations | No serious limitations | No serious limitations | No serious limitations | Undetected | 47 of 550 (8·5) |
561 of 562 (99·8) |
91·8 (88·2, 94·8)% Favours antibiotic therapy |
High | |
| Length of hospital stay | ||||||||||
|
1100 (5) In hospital |
No serious limitations | No serious limitations | Serious limitations: most patients operated on using open approach; laparoscopic approach would shorten length of hospital stay | No serious limitations | Undetected |
0·41 (0·26 to 0·57) days Favours appendicectomy |
Moderate | |||
| Length of sick leave | ||||||||||
|
1017 (3) 1 month |
No serious limitations | Serious limitations: inconsistent forest plot estimates | Serious limitations: most patients operated on using open approach; laparoscopic approach would shorten length of sick leave | Serious limitations: 95% confidence interval crosses 0, indicating no difference | Undetected |
−3·58 (−8·27, 1·11) days Favours antibiotic therapy |
Very low | |||
Values in parentheses are percentages unless indicated otherwise; values are
*
number of studies and
†
95 per cent confidence interval.