Table 2.
Ultrasound imaging compared with palpation method for neonates and infants getting a lumbar puncture | ||||||
Patient or population: neonates and infants getting a lumbar puncture. Setting: ED or paediatric ward. Intervention: U=ultrasound imaging. Comparison: palpation method. | ||||||
Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) |
No. of participants (studies) |
Certainty of the evidence (GRADE) |
Comments | |
Risk with palpation method | Risk with ultrasound imaging | |||||
Risk of failure | 163 per 1000 |
95 per 1000
(41 to 294) |
RR 0.58
(0.25 to 1.80) |
277 (4 RCTs) |
⨁⨁⨁◯ Moderate |
Ultrasound imaging reduces the risk of failure when performing a lumbar puncture. |
Risk of having a traumatic tap | 256 per 1000 |
136 per 1000
(85 to 213) |
RR 0.53
(0.33 to 0.83) |
308 (4 RCTs) |
⨁⨁⨁◯ Moderate* |
Ultrasound imaging reduces the risk of a traumatic tap when performing a lumbar puncture. |
GRADE Working Group grades of evidence.
High certainty: we are very confident that the true effect lies close to that of the estimate of the effect.
Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.
Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect
Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect.
*The risk in the intervention group (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
RCT, randomised clinical trial; RR, risk ratio.