Summary of findings for the main comparison. Systemic administration of beta‐blockers compared to placebo or no treatment for prevention of retinopathy of prematurity in preterm infants.
| Systemic administration of beta‐blockers compared to placebo or no treatment for prevention of retinopathy of prematurity in preterm infants | ||||||
| Patient or population: Prevention of retinopathy of prematurity in preterm infants Setting: Neonatal clinical care units Intervention: Systemic beta‐blockers Comparison: Placebo or no treatment | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Risk with placebo or no treatment | Risk with Beta‐blockers | |||||
| Severe visual impairment or blindness at 6 to 12 months' corrected age | N/A | N/A | N/A | N/A | N/A | None of the studies reported on this outcome. |
| Rescue treatment with anti‐VEGF agents | 86 per 1000 | 27 per 1000 (10 to 74) | RR 0.32 (0.12 to 0.86) | 366 (3 RCTs) | ⊕⊕⊝⊝ LOW | Unblinded studies, incomplete outcome data, imprecision of point estimate, few events. |
| Treatment with laser photocoagulation or cryotherapy | 194 per 1000 | 105 per 1000 (62 to 173) | RR 0.54 (0.32 to 0.89) | 366 (3 RCTs) | ⊕⊕⊝⊝ LOW | Unblinded studies, incomplete outcome data, imprecision of point estimate. |
| Progression to stage 2 with plus disease | 38 per 1000 | 9 per 1000 (1 to 81) |
RR 0.25 (0.03 to 2.16) |
161 (2 RCTs) |
⊕⊕⊕⊝ MODERATE | Imprecision of point estimates, few events, 95% CI includes both 1) no effect and 2) appreciable benefit or appreciable harm. |
| Progression to stage 3 ROP | 375 per 1000 | 225 per 1000 (139 to 360) | RR 0.60 (0.37 to 0.96) | 161 (2 RCTs) | ⊕⊕⊕⊝ MODERATE | Imprecision of point estimate, few events. |
| Progression to stage 4 or 5 ROP | 50 per 1000 | 6 per 1000 (1 to 98) | RR 0.11 (0.01 to 1.96) | 161 (2 RCTs) | ⊕⊕⊕⊝ MODERATE | Few events, 95% CI includes both 1) no effect and 2) appreciable benefit or appreciable harm. |
| Arterial hypotension and/or bradycardia requiring treatment | 0 per 1000 | 0 per 1000 (0 to 0) | RR 24.35 (1.32 to 448.50) | 366 (3 RCTs) | ⊕⊕⊝⊝ LOW | Unblinded studies, few events. |
| *The risk in the intervention group (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). 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 the 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 | ||||||