Table 2.

GRADE Evidence Profile for Oral Oseltamivir Received Within or After 48 Hours

Outcome	Quality Assessment		Summary of Findings
	Patients (Studies), n*	Overall Quality of Evidence	Study Event Rates, n/N (%)		Relative Effect (95% CI)	Anticipated Absolute Effects
			Oseltamivir Received >48 h	Oseltamivir Received ≤48 h		Risk With Oseltamivir Received >48 h	Absolute Effect With Oseltamivir Received ≤48 h (95% CI)
Mortality	2141 (8)	Very low due to imprecision and risk of bias†‡§	1163	978	OR, 0.33 (0.12–0.86)	200 deaths per 1000 patients‖	124 fewer deaths (23 to 169 fewer deaths) per 1000 patients
Hospitalization	597 (2)	Very low due to risk of bias†§¶	144/316 (45.6)	151/281 (53.7)	OR, 0.52 (0.33–0.81)	456 hospitalizations per 1000 patients	152 fewer hospitalizations (52 to 239 fewer hospitalizations) per 1000 patients
ICU admission, mechanical ventilation, or respiratory failure	1102 (4)	Very low due to risk of bias†§¶	120/474 (25.3)	44/628 (7)	OR, 0.22 (0.15–0.33)	253 admissions per 1000 patients	184 fewer admissions (153 to 205 fewer admissions) per 1000 patients
Duration of hospitalization**	79 (1)††	Very low due to imprecision and risk of bias†§‡‡	43	36	-	-	Mean duration of hospitalization was 24 h shorter (0 to 48 h shorter)††
Duration of signs and symptoms§§	267 (1)‖‖	Very low due to imprecision and risk of bias†‡§‖	178	89	-	-	Mean time was 6.16 more hours (5.76 fewer to 18.08 more hours)‖‖
Critical complication	899 (2)	Very low due to risk of bias†§	38/557 (6.8)	29/342 (8.5)	OR, 1.22 (0.44–3.36)	68 complications per 1000 patients	14 more complications (37 fewer to 129 more complications) per 1000 patients
Viral shedding¶¶	70 (1)	Very low due to imprecision and risk of bias†§‡‡	18/34 (52.9)	8/36 (22.2)	OR, 0.25 (0.09–0.71)	529 cases of persistent virus per 1000 patients	310 fewer cases of persistent virus (85 to 437 fewer cases) per 1000 patients***

GRADE = Grading of Recommendations Assessment, Development, and Evaluation; ICU = intensive care unit; OR = odds ratio.

^*Follow-up to 30 d.

^†Not adjusted for potential confounding factors.

^‡Effect includes possible important benefit or harm.

^§Although we did not downgrade, publication bias cannot be excluded.

^‖Calculated from studies with event rates.

^¶Not downgraded, but one half of patients were pregnant women.

^**Lower values indicate better outcome

^††Another study reported increased duration with late treatment (adjusted hazards ratio, 1.28 [95% CI, 1.04–1.57]).

^‡‡This study had few events and patients.

^§§Lower values indicate better outcome. Time to return to normal activity was not measured.

^‖‖Two other studies reported greater time to alleviation of symptoms when oseltamivir was received after 48 h.

^¶¶Measured at 7 d

^***Two other studies found fewer patients with detectable viral RNA in the early therapy group and longer duration of viral shedding in the late therapy group.