Summary of findings for the main comparison. SDAC versus no intervention for first aid in patients with acute oral poisoning.
| SDAC versus no intervention for first aid in patients with acute oral poisoning | ||||||
| Patient or population: first aid in patients with acute oral poisoning (paracetamol or not specified) Setting: hospital setting Intervention: single‐dose activated charcoal (SDAC) Comparison: no intervention | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with no intervention | Risk with SDAC | |||||
| Incidence of mortality | No studies collected or reported this outcome | |||||
| Incidence of adverse events | Control group: 0/236; intervention group: 4/240 (Peto OR 4.17, 95% CI 0.30 to 57.26) | — | 476 (2 RCTs) | ⊕⊝⊝⊝ Very lowa,b,c | We are uncertain of the effect of SDAC on the incidence of adverse events. | |
| Incidence and severity of symptoms of poisoning: incidence of clinical deterioration during stay in the hospital | — | — | 451 (1 RCT) | ⊕⊝⊝⊝ Very lowa,b,d | The relative effect was not estimable due to the absence of events in the intervention (0/220) and the control group (0/231). We are uncertain of the effect of SDAC on incidence and severity on poisoning. | |
| Duration of toxic symptoms | No studies collected or reported this outcome | |||||
| Drug absorption | No studies collected or reported this outcome | |||||
| Incidence of hospitalization | No studies collected or reported this outcome | |||||
| Incidence of ICU admission | Control group: 0/231; intervention group: 1/220 (Peto OR 7.77, 95% CI 0.15 to 391.93) | — | 451 (1 RCT) | ⊕⊝⊝⊝ Very lowa,b,c | We are uncertain of the effect of SDAC on the incidence of ICU admission. | |
| *The risk in the intervention group (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; ICU: intensive care unit; MD: mean difference; RCT: randomized controlled trial; RR: risk ratio; SDAC: single‐dose activated charcoal; OR: odds ratio. | ||||||
| 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. | ||||||
aDowngraded one level for serious limitations in study design: high risk of selection bias. bDowngraded one level for serious indirectness: study conducted in a hospital setting. cDowngraded one level for serious imprecision: low number of events and wide confidence intervals. dDowngraded one level for serious imprecision: low number of events.