Table 5.
Summary of findings: Combined versus alternating therapy for fever in children
| Combined versus alternating therapy for fever in children | |||||||
| Patient or population: children with fever Intervention: alternating versus combined therapy | |||||||
| Outcomes | Timepoint | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | ||||||
| Alternating therapy | Combinedtherapy | ||||||
| Mean Temperature | 1 hour | The mean temperature in the control group was 37.6 °C | The mean temperature in the intervention groups was 0.2 °C lower (0.48 °C lower to 0.08 °C higher) | ‐ | 40 (1 study) | ⊕⊝⊝⊝ very low1,2,3 | |
| 4 hours | The mean temperature in the control group was 36.9 °C | The mean temperature in the intervention groups was 0 °C higher (0.19 °C lower to 0.19 °C higher) | ‐ | 40 (1 study) | ⊕⊝⊝⊝ very low1,2,3 | ||
| 6 hours | The mean temperature in the control group was 36.9 °C | The mean temperature in the intervention groups was 0.3 °C higher (0.01 °C to 0.59 °C higher) | ‐ | 40 (1 study) | ⊕⊝⊝⊝ very low1,2,3 | ||
| Proportion Febrile | 1 hour | 200 per 1000 | 100 per 1000 (20 to 486) | RR 0.5 (0.1 to 2.43) | 40 (1 study) | ⊕⊝⊝⊝ very low1,2,3 | |
| 4 hours | ‐ | ‐ | Not estimable | 40 (1 study) | ⊕⊝⊝⊝ very low1,2,3 | ||
| 6 hours | 0 per 1000 | 0 per 1000 (0 to 0) | RR 3 (0.13 to 69.52) | 40 (1 study) | ⊕⊝⊝⊝ very low1,2,3 | ||
| *The basis for the assumed risk (eg 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). 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 This single study was conducted in the USA. 2 Downgraded by 1 for risk of bias: this study was at unclear risk of selection bias as allocation concealment was not described. 3 Downgraded by 2 for very serious imprecision due to the very small sample size.