3.
| Codeine compared with promethazine in people with breathlessness in advanced disease or terminal illness | ||||||
|
Patient or population: adults with refractory breathlessness Setting: outpatient setting Intervention: codeine Comparison: promethazine | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | Number of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Promethazine | Codeine | |||||
| Breathlessness: post‐treatment score1 | The mean dyspnoea score in the promethazine group was 6 | The mean post‐treatment score was 0.30 points lower in the codeine group (ranging from 0.83 points lower to 0.23 points higher) | — | 7 (1 RCT) | ⊕⊝⊝⊝ very low2,3,4 | A lower score indicates an improvement in breathlessness |
| *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% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). | ||||||
| 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. | ||||||
1Breathlessness was assessed according to the oxygen cost diagram at 1 month. 2Limitations in the design and implementation of available studies suggesting a high risk of bias. 3Only one study. 4Significant heterogeneity.
Abbreviations: RCT: randomised controlled trial; CI: confidence interval; RR: risk ratio.