Summary of findings for the main comparison. PPE‐types: One type of PPE versus another – PAPR versus E‐RCP attire.
PAPR versus E‐RCP Attire for preventing contact with contaminated body fluids in healthcare staff | ||||||
Patient or population: Healthcare staff volunteers
Settings: Simulation study
Intervention: PPE with Powered Air Purifying Respirator (PAPR) Attire Control: Enhanced respiratory and contact precautions (E‐RCP) attire according to 2005 CDC recommendation | ||||||
Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
Assumed risk | Corresponding risk | |||||
E‐RCP attire | PAPR Attire | |||||
Any contamination
fluorescent marker Follow‐up: post intervention |
960 per 1000 | 259 per 1000 (163 to 413) | RR 0.27 (0.17 to 0.43) | 50 (1 cross‐over RCT) | ⊕⊝⊝⊝ very low1,2,3 | Analyses presented in this table are unadjusted for the paired nature of the cross‐over design but similar to the results that the authors presented while taking the cross‐over into account |
Compliance with guidance ‐ Noncompliance with donning guidance Follow‐up: post intervention |
40 per 1000 | 300 per 1000 (72 to 1000) | RR 7.5 (1.81 to 31.1) | 50 (1 cross‐over RCT) | ⊕⊝⊝⊝ very low1,2,3 | |
Compliance with guidance ‐ Noncompliance with doffing guidance Follow‐up: post intervention |
240 per 1000 | 120 per 1000 (48 to 295) | RR 0.5 (0.2 to 1.23) | 50 (1 cross‐over RCT) | ⊕⊝⊝⊝ very low1,2,3 | |
Infection with EVD | See comment | See comment | Not estimable | 0 (0 studies) | See comment | No studies evaluated the effect of the interventions on infection rates. |
*The basis for the assumed risk is the control group risk. 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 Simulation study, downgraded one level for indirectness 2 One cross‐over study with 50 participants, downgraded one level for imprecision
3 HIgh risk of bias, downgraded one level for study limitations