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. 2019 Jan 31;2019(1):CD006471. doi: 10.1002/14651858.CD006471.pub4

Summary of findings for the main comparison. Braden pressure ulcer risk assessment and training compared with pressure ulcer risk assessment using clinical judgement and training for the prevention of pressure ulcers.

Braden pressure ulcer risk assessment and training compared with pressure ulcer risk assessment using clinical judgement and training for the prevention of pressure ulcers
Patient or population: patients at risk of pressure ulcers
 Setting: hospital setting
 Intervention: Braden pressure ulcer risk assessment and training
 Comparison: pressure ulcer risk assessment using clinical judgement and training
Outcomes Illustrative comparative risks* (95% CI) Relative effect
 (95% CI) Absolute effect
(95% CI)
No of Participants
 (studies) Quality of the evidence
 (GRADE) Comments
Assumed risk Corresponding risk
Pressure ulcer risk assessment using clinical judgement and training Braden pressure ulcer risk assessment and training
Pressure ulcer incidence
 Visual skin assessment
 Follow‐up: 8 weeks Study population RR 0.97 
 (0.53 to 1.77) 7 fewer per 1000 (from 105 fewer to 172 more) 150
 (1 study) ⊕⊝⊝⊝
 Very low1 We are uncertain if Braden pressure ulcer risk assessment and training, compared with pressure ulcer risk assessment using clinical judgement and training, makes any difference to pressure ulcer incidence.
224 per 1000 217 per 1000
 (119 to 396)
Severity of new pressure ulcers
Time to ulcer development
Pressure ulcer prevalence
Not reported
*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 Downgraded twice for study limitations due to high risk of performance and detection bias and unclear risk of selection and attrition bias; downgraded twice for imprecision due to wide confidence intervals, small sample size and no allowance for the use of cluster randomisation.