Summary of findings 2. COMPARISON 2. ARIPIPRAZOLE versus QUETIAPINE for schizophrenia.
| COMPARISON 2. ARIPIPRAZOLE versus QUETIAPINE for schizophrenia | ||||||
| Patient or population: patients with schizophrenia Settings: inpatient and outpatient Intervention: COMPARISON 2. ARIPIPRAZOLE versus QUETIAPINE | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Control | COMPARISON 2. ARIPIPRAZOLE versus QUETIAPINE | |||||
| Global state: No clinically significant response (as defined by original studies) | Low1 | RR 0.92 (0.64 to 1.32) | 991 (12 studies) | ⊕⊕⊝⊝ low2,3 | ||
| 50 per 1000 | 46 per 1000 (32 to 66) | |||||
| Moderate1 | ||||||
| 100 per 1000 | 92 per 1000 (64 to 132) | |||||
| High1 | ||||||
| 150 per 1000 | 138 per 1000 (96 to 198) | |||||
| Mental state: as assessed by PANSS positive symptom scale score PANSS positive symptom subscale (high score = poor) Follow‐up: up to 12 weeks | The mean mental state: as assessed by PANSS positive symptom scale score in the intervention groups was 0.97 lower (2.34 lower to 0.41 higher) | 583 (7 studies) | ⊕⊝⊝⊝ very low4,5,6,7 | |||
| Leaving the study early Follow‐up: up to 12 weeks | Low1 | RR 0.8 (0.22 to 2.87) | 168 (2 studies) | ⊕⊝⊝⊝ very low2,8 | ||
| 0 per 1000 | 0 per 1000 (0 to 0) | |||||
| Moderate1 | ||||||
| 50 per 1000 | 40 per 1000 (11 to 143) | |||||
| High1 | ||||||
| 100 per 1000 | 80 per 1000 (22 to 287) | |||||
| Quality of life: as measured by WHO‐QOL‐100 Follow‐up: up to 12 weeks | The mean quality of life: as measured by WHO‐QOL‐100 in the intervention groups was 2.6 higher (1.31 to 3.89 higher) | 100 (1 study) | ⊕⊝⊝⊝ very low8,9,10,11 | |||
| Adverse effects: extrapyramidal symptoms Follow‐up: up to 12 weeks | Low1 | RR 2.8 (0.64 to 12.31) | 348 (4 studies) | ⊕⊝⊝⊝ very low2,7,12,13 | ||
| 0 per 1000 | 0 per 1000 (0 to 0) | |||||
| Moderate1 | ||||||
| 50 per 1000 | 140 per 1000 (32 to 616) | |||||
| High1 | ||||||
| 100 per 1000 | 280 per 1000 (64 to 1000) | |||||
| General functioning ‐ not measured | See comment | See comment | Not estimable | ‐ | See comment | No study measured or reported this outcome. |
| Service use ‐ not measured | See comment | See comment | Not estimable | ‐ | See comment | No study measured or 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. | ||||||
1 Risk: moderate risk approximately equates to that of the control group risk in the study population. 2 Risk of bias: rated 'serious' – majority of the included studies had inadequate study design ‐ unclear randomisation, allocation concealment and blinding. A large proportion of them also had selective reporting concerns. 3 Imprecision: rated 'serious' – most of these included studies are of small samples with small effect size and wide confidence interval. The 95% confidence interval of the combined estimated effect was not statistically significant. 4 Imprecision and risk of bias: rated 'serious' ‐ most of the studies included are of small sample size, the overall pooled estimate of effect is not significant. 5 Inconsistency: rated 'serious' ‐ unexplained heterogeneity is high (70%). 6 Indirectness: rated 'serious' ‐ we were unable to obtain direct binary measure of mental state, thus used the best approximate measure available as an indicator. 7 Publication bias: rated 'strongly suspected' ‐ only small number of studies were identified ‐ publication bias likely. 8 Imprecision and publication bias: rated 'serious' ‐ only small number of studies with poor methodological design favouring intervention group were identified ‐ publication bias likely 9 Risk of bias: rated 'serious' – the only included study has unclear study design (randomisation, allocation concealment, blinding were unclear) and concerns of selective reporting. 10 Indirectness: rated 'serious' ‐ we are unable to obtain a direct binary measure of quality of life, thus used the best available proximate measure of WHO‐QOL‐100 as an indicator. 11 Imprecision: rated 'very serious' ‐ only one study is available on this outcome. The sample size is small and the CI of effect estimate is wide. 12 Inconsistency: rated 'serious' ‐ unexplained heterogeneity is around 53%. 13 Imprecision: rated 'serious' ‐ overall event rate is small (<300).