Summary of findings 3. Ear drops (water or saline) compared with no treatment for ear wax.

Ear drops (water or saline) compared with no treatment for ear wax
Patient or population: adults and children with ear wax requiring removal Settings: primary care Intervention: water or saline ear drops Comparison: no treatment
Outcomes	Illustrative comparative risks* (95% CI)		Relative effect (95% CI)	No of participants (studies)	Quality of the evidence (GRADE)	Comments
	Assumed risk	Corresponding risk
	No treatment	Water or saline
Proportion of patients (or ears) with complete clearance of ear wax	5 per 100	21 per 100	RR 4.00, 95% CI 0.91 to 17.62	48 participants; 76 ears (1 study)	⊕⊕⊝⊝ Low1,2	—
Adverse effects: discomfort, irritation or pain	This study reported "excellent" patient acceptability of ear drops, reporting no adverse effects of discomfort, irritation or pain in either group.				⊕⊕⊝⊝ Low1,2	—
*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: we are very confident that the true effect lies close to that of the estimate of the effect; Moderate quality: we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of effect, but there is a possibility that it is substantially different; Low quality: our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect; Very low quality: we have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect.

¹Downgraded by one level for imprecision (one study with a large confidence interval).

²Downgraded by one level due to study limitations (unclear risk of bias).