Table 3.
GRADE evidence profile SCIT
| Quality assessment | Number of patients | Effect | Quality | Importance | ||||||||
| Number of studies | Study design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | SCIT | No intervention | Relative (95% CI) | Absolute (95% CI) | ||
| Asthma symptoms (assessed with: asthma symptom scores) | ||||||||||||
| 5* | RCT | Very serious† | Not serious | Serious‡ | Not serious | None | 136 | 286 | – | Standardised mean difference −0.04 (95%CI −0.42 to 0.33) | ⨁OOO VERY LOW |
CRITICAL |
| Exacerbations (assessed with: symptomatic deterioration) | ||||||||||||
| 5* | RCT | Serious§ | Not serious | Very serious¶ | Not serious | None | 64/253 (25.3%) | 92/153 (60.1%) | Risk ratio 0.7 (0.31 to 0.72) | 343 fewer per 1000 (95%CI −397 to −265) | ⨁OOO VERY LOW |
CRITICAL |
| Asthma control: not reported | ||||||||||||
| – | – | – | – | – | – | – | – | – | – | – | – | CRITICAL |
| Quality of life: not reported | ||||||||||||
| – | – | – | – | – | – | – | – | – | – | – | – | IMPORTANT |
| Lung function: not reported | ||||||||||||
| – | – | – | – | – | – | – | – | – | – | – | – | IMPORTANT |
†The underlying studies had a quite large risk of bias, due to lack of allocation concealment, problems with blinding and lack of information on follow-up (and lost to follow-up).
‡We downgraded for indirectness, because the included studies are quite old and maintenance medication may have changed probably; thus, study populations may differ from nowadays patients with moderate to severe asthma.
§We downgraded for risk of bias, because of problems with blinding and lost to follow-up.
¶We assessed very serious indirectness, because most included studies for this outcome are very old, and carried out before the ICS era; thus, patients nowadays differ from study populations.
GRADE, Grading of Recommendations Assessment, Development and Evaluation; ICS, inhaled corticosteroids; RCT, randomised controlled trial; SCIT, subcutaneous immunotherapy.