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. 2018 Dec 19;2018(12):CD013230. doi: 10.1002/14651858.CD013230
SDAC + cathartic compared to SDAC + cathartic (different type) for first aid in patients with acute oral poisoning
Patient or population: first aid in patients with acute oral poisoning (combination of different drugs)
 Setting: hospital setting
 Intervention: single‐dose activated charcoal (SDAC) + cathartic
 Comparison: SDAC + cathartic (different type)
Outcomes Anticipated absolute effects* (95% CI) Relative effect
 (95% CI) № of participants
 (studies) Certainty of the evidence
 (GRADE) Comments
Risk with SDAC + Cathartic (different type) Risk with SDAC + Cathartic
Incidence of mortality No studies collected or reported this outcome
Incidence of adverse events: vomiting (sorbitol vs magnesium citrate) Study population RR 2.23
 (0.97 to 5.16) 65
 (1 RCT) ⊕⊝⊝⊝
 Very lowa,b,c We are uncertain about the effect of different types of cathartics combined with SDAC on the incidence of adverse events.
182 per 1000 405 per 1000
 (176 to 938)
Incidence and severity of symptoms of poisoning ‐ not reported No studies collected or reported this outcome
Duration of toxic symptoms No studies collected or reported this outcome
Drug absorption No studies collected or reported this outcome
Incidence of hospitalization admission No studies collected or reported this outcome
Incidence of ICU admission No studies collected or reported this outcome
*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; RR: risk ratio; RCT: randomized controlled trial; SDAC: single‐dose activated charcoal.
GRADE Working Group grades of evidenceHigh 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.