Summary of findings 2. HALOPERIDOL + PROMETHAZINE compared to ANTIPSYCHOTIC ‐ OLANZAPINE for psychosis‐induced aggression.
| HALOPERIDOL + PROMETHAZINE compared to ANTIPSYCHOTIC ‐ OLANZAPINE for psychosis‐induced aggression | ||||||
| Patient or population: people with psychosis‐induced aggression Settings: Intervention: HALOPERIDOL + PROMETHAZINE Comparison: ANTIPSYCHOTIC ‐ OLANZAPINE | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| ANTIPSYCHOTIC ‐ OLANZAPINE | HALOPERIDOL + PROMETHAZINE | |||||
| Tranquil or asleep: Not tranquil or asleep ‐ by 30 mins | Moderate1 | RR 0.60 (0.22 to 1.61) | 300 (1 study) | ⊕⊕⊕⊕ high | ||
| 100 per 1000 | 60 per 1000 (22 to 161) | |||||
| Global state: Needing restraints or seclusion by 12 hours | Moderate | RR 5.00 (0.62 to 40.28) | 60 (1 study) | ⊕⊕⊝⊝ low2,3 | ||
| 50 per 10001 | 250 per 1000 (31 to 1000) | |||||
| Adverse effects: Specific and serious adverse effects by 24 hours Central nervous system ‐ excessive sedation. | Moderate | RR 0.67 (0.12 to 3.84) | 116 (2 studies) | ⊕⊕⊝⊝ low4,5 | ||
| 100 per 10001 | 64 per 1000 (11 to 364) | |||||
| Adverse effect: Specific ‐ Death | See comment | See comment | Not estimable | 0 (0) | See comment | No study reported this outcome |
| Service outcomes: Not discharged ‐ by 4 hours | Moderate | RR 0.94 (0.77 to 1.16) | 300 (1 study) | ⊕⊕⊕⊕ high | ||
| 600 per 10001 | 564 per 1000 (462 to 696) | |||||
| Specific behaviours: Average aggression score ‐ by 12 hours Overt Aggression Scale | The mean specific behaviours: average aggression score in the intervention groups was 2 lower (2.21 to 1.79 lower) | 60 (1 study) | ⊕⊕⊝⊝ low5,6 | |||
| Economics: Costs of care7 | See comment | See comment | Not estimable | 0 (0) | See comment | No study reported this outcome |
| *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. | ||||||
1Moderate control risk approximates to that of the included trial(s). 2Indirectness: rated 'serious' ‐ pre‐stated outcome was 'another episode of aggression' ‐ proxy outcome used. 3Imprecision: rated 'serious' as sample size too small and confidence interval too wide. 4Indirectness: rated 'serious' ‐ pre‐stated outcome was 'serious adverse effect' ‐ proxy outcome used. 5Imprecision: rated 'serious' ‐ sample size too small and confidence interval wide. 6Indirectness: rated 'serious' ‐ pre‐stated outcome was 'specific behaviours' ‐ proxy outcome used.