Comparison 20.
Appearance of encephalopathy ‐ absolute risk difference (ARD)
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
|---|---|---|---|---|
| 1 All studies | 23 | Risk Difference (M‐H, Fixed, 95% CI) | Subtotals only | |
| 1.1 All trials | 23 | 1062 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.02 [‐0.06, 0.01] |
| 1.2 Standard amino acids | 11 | 339 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.02 [‐0.09, 0.05] |
| 1.3 BCAAs | 15 | 772 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.03 [‐0.07, 0.01] |
| 2 Parenteral nutrition ‐ all trials | 5 | Risk Difference (M‐H, Fixed, 95% CI) | Subtotals only | |
| 2.1 All trials | 5 | 231 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.05 [‐0.13, 0.02] |
| 2.2 Standard amino acids | 3 | 87 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.09 [‐0.23, 0.04] |
| 2.3 BCAAs | 2 | 144 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.03 [‐0.12, 0.05] |
| 3 Parenteral nutrition ‐ medical trials | 3 | Risk Difference (M‐H, Fixed, 95% CI) | Subtotals only | |
| 3.1 All trials | 3 | 87 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.09 [‐0.23, 0.04] |
| 3.2 Standard amino acids | 3 | 87 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.09 [‐0.23, 0.04] |
| 3.3 BCAAs | 0 | 0 | Risk Difference (M‐H, Fixed, 95% CI) | 0.0 [0.0, 0.0] |
| 4 Parenteral nutrition ‐ surgical trials | 2 | Risk Difference (M‐H, Fixed, 95% CI) | Subtotals only | |
| 4.1 A;ll trials | 2 | 144 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.03 [‐0.12, 0.05] |
| 4.2 Standard amino acids | 0 | 0 | Risk Difference (M‐H, Fixed, 95% CI) | 0.0 [0.0, 0.0] |
| 4.3 BCAAs | 2 | 144 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.03 [‐0.12, 0.05] |
| 5 Enteral nutrition ‐ all studies | 4 | Risk Difference (M‐H, Fixed, 95% CI) | Subtotals only | |
| 5.1 All trials | 4 | 102 | Risk Difference (M‐H, Fixed, 95% CI) | 0.10 [‐0.04, 0.25] |
| 5.2 Standard amino acids | 4 | 91 | Risk Difference (M‐H, Fixed, 95% CI) | 0.08 [‐0.07, 0.24] |
| 5.3 BCAAs | 1 | 24 | Risk Difference (M‐H, Fixed, 95% CI) | 0.21 [‐0.14, 0.56] |
| 6 Enteral nutrition ‐ medical trials | 4 | Risk Difference (M‐H, Fixed, 95% CI) | Subtotals only | |
| 6.1 All studies | 4 | 102 | Risk Difference (M‐H, Fixed, 95% CI) | 0.04 [‐0.10, 0.18] |
| 6.2 Standard amino acids | 4 | 91 | Risk Difference (M‐H, Fixed, 95% CI) | 0.08 [‐0.07, 0.24] |
| 6.3 BCAAs | 1 | 24 | Risk Difference (M‐H, Fixed, 95% CI) | 0.21 [‐0.14, 0.56] |
| 7 Enteral nutrition ‐ surgical trials | 0 | Risk Difference (M‐H, Fixed, 95% CI) | Subtotals only | |
| 7.1 All trials | 0 | 0 | Risk Difference (M‐H, Fixed, 95% CI) | 0.0 [0.0, 0.0] |
| 7.2 Standard amino acids | 0 | 0 | Risk Difference (M‐H, Fixed, 95% CI) | 0.0 [0.0, 0.0] |
| 7.3 BCAAs | 0 | 0 | Risk Difference (M‐H, Fixed, 95% CI) | 0.0 [0.0, 0.0] |
| 8 Supplements | 14 | Risk Difference (M‐H, Fixed, 95% CI) | Subtotals only | |
| 8.1 All trials | 14 | 734 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.03 [‐0.07, 0.01] |
| 8.2 Standard amino acids ‐medical trials | 4 | 170 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.04 [‐0.13, 0.05] |
| 8.3 BCAAs ‐ medical trials | 10 | 536 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.04 [‐0.09, 0.01] |
| 8.4 All supplements ‐ medical | 12 | 666 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.04 [‐0.08, 0.01] |
| 8.5 All surgical | 2 | 68 | Risk Difference (M‐H, Fixed, 95% CI) | 0.0 [‐0.08, 0.08] |
| 9 Medical trials all trials | 19 | 846 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.02 [‐0.07, 0.02] |
| 9.1 Parenteral nutrition | 3 | 87 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.09 [‐0.23, 0.04] |
| 9.2 Enteral nutrition | 4 | 102 | Risk Difference (M‐H, Fixed, 95% CI) | 0.10 [‐0.04, 0.25] |
| 9.3 Supplements | 12 | 657 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.03 [‐0.08, 0.01] |
| 10 Medical trials ‐ standard amino acids | 11 | 339 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.02 [‐0.09, 0.05] |
| 10.1 Parenteral nutrition | 3 | 87 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.09 [‐0.23, 0.04] |
| 10.2 Enteral nutrition | 4 | 91 | Risk Difference (M‐H, Fixed, 95% CI) | 0.08 [‐0.07, 0.24] |
| 10.3 Supplements | 4 | 161 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.03 [‐0.13, 0.06] |
| 11 Medical trials ‐ BCAAs | 11 | 560 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.03 [‐0.08, 0.02] |
| 11.1 Parenteral nutrition | 0 | 0 | Risk Difference (M‐H, Fixed, 95% CI) | 0.0 [0.0, 0.0] |
| 11.2 Enteral nutrition | 1 | 24 | Risk Difference (M‐H, Fixed, 95% CI) | 0.21 [‐0.14, 0.56] |
| 11.3 Supplements | 10 | 536 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.04 [‐0.09, 0.01] |
| 12 Surgical trials ‐ all studies | 4 | 212 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.02 [‐0.09, 0.04] |
| 12.1 Parenteral nutrition | 2 | 144 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.03 [‐0.12, 0.05] |
| 12.2 Enteral nutrition | 0 | 0 | Risk Difference (M‐H, Fixed, 95% CI) | 0.0 [0.0, 0.0] |
| 12.3 Supplements | 2 | 68 | Risk Difference (M‐H, Fixed, 95% CI) | 0.0 [‐0.08, 0.08] |
| 13 Surgical trials ‐ standard amino acids | 0 | 0 | Risk Difference (M‐H, Fixed, 95% CI) | 0.0 [0.0, 0.0] |
| 13.1 Parenteral nutrition | 0 | 0 | Risk Difference (M‐H, Fixed, 95% CI) | 0.0 [0.0, 0.0] |
| 13.2 Enteral nutrition | 0 | 0 | Risk Difference (M‐H, Fixed, 95% CI) | 0.0 [0.0, 0.0] |
| 13.3 Supplements | 0 | 0 | Risk Difference (M‐H, Fixed, 95% CI) | 0.0 [0.0, 0.0] |
| 14 Surgical trials ‐ BCAAs | 4 | 212 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.02 [‐0.09, 0.04] |
| 14.1 Parenteral nutrition | 2 | 144 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.03 [‐0.12, 0.05] |
| 14.2 Enteral nutrition | 0 | 0 | Risk Difference (M‐H, Fixed, 95% CI) | 0.0 [0.0, 0.0] |
| 14.3 Supplements | 2 | 68 | Risk Difference (M‐H, Fixed, 95% CI) | 0.0 [‐0.08, 0.08] |
| 15 Alcoholic hepatitis ‐ all studies | 6 | 172 | Risk Difference (M‐H, Fixed, 95% CI) | 0.02 [‐0.07, 0.12] |
| 15.1 Parenteral nutrition | 2 | 47 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.09 [‐0.25, 0.07] |
| 15.2 Enteral nutrition | 2 | 48 | Risk Difference (M‐H, Fixed, 95% CI) | 0.14 [‐0.09, 0.37] |
| 15.3 Supplements | 2 | 77 | Risk Difference (M‐H, Fixed, 95% CI) | 0.02 [‐0.11, 0.16] |
| 16 Alcoholic hepatitis ‐ standard amino acids | 6 | 161 | Risk Difference (M‐H, Fixed, 95% CI) | 0.01 [‐0.09, 0.11] |
| 16.1 Parenteral nutrition | 2 | 47 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.09 [‐0.25, 0.07] |
| 16.2 Enteral nutrition | 2 | 37 | Risk Difference (M‐H, Fixed, 95% CI) | 0.11 [‐0.15, 0.36] |
| 16.3 Supplements | 2 | 77 | Risk Difference (M‐H, Fixed, 95% CI) | 0.02 [‐0.11, 0.16] |
| 17 Alcoholic hepatitis ‐ BCAA | 1 | 24 | Risk Difference (M‐H, Fixed, 95% CI) | 0.21 [‐0.14, 0.56] |
| 17.1 Parenteral nutrition | 0 | 0 | Risk Difference (M‐H, Fixed, 95% CI) | 0.0 [0.0, 0.0] |
| 17.2 Enteral nutrition | 1 | 24 | Risk Difference (M‐H, Fixed, 95% CI) | 0.21 [‐0.14, 0.56] |
| 17.3 Supplements | 0 | 0 | Risk Difference (M‐H, Fixed, 95% CI) | 0.0 [0.0, 0.0] |
| 18 Cirrhosis ‐ all studies | 12 | 420 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.04 [‐0.10, 0.02] |
| 18.1 Parenteral nutrition | 1 | 40 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.1 [‐0.32, 0.12] |
| 18.2 Enteral nutrition | 2 | 54 | Risk Difference (M‐H, Fixed, 95% CI) | 0.07 [‐0.12, 0.26] |
| 18.3 Supplements | 9 | 326 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.05 [‐0.11, 0.01] |
| 19 Cirrhosis ‐ standard amino acids | 6 | 229 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.01 [‐0.09, 0.08] |
| 19.1 Parenteral nutrition | 1 | 40 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.1 [‐0.32, 0.12] |
| 19.2 Enteral nutrition | 2 | 54 | Risk Difference (M‐H, Fixed, 95% CI) | 0.07 [‐0.12, 0.26] |
| 19.3 Supplements | 3 | 135 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.01 [‐0.12, 0.10] |
| 20 Cirrhosis ‐ BCAAs | 8 | 231 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.05 [‐0.13, 0.02] |
| 20.1 Parenteral nutrition | 0 | 0 | Risk Difference (M‐H, Fixed, 95% CI) | 0.0 [0.0, 0.0] |
| 20.2 Enteral nutrition | 0 | 0 | Risk Difference (M‐H, Fixed, 95% CI) | 0.0 [0.0, 0.0] |
| 20.3 Supplementss | 8 | 231 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.05 [‐0.13, 0.02] |
| 21 HCC ‐ all studies | 2 | 305 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.03 [‐0.09, 0.04] |
| 21.1 Parenteral nutrition | 0 | 0 | Risk Difference (M‐H, Fixed, 95% CI) | 0.0 [0.0, 0.0] |
| 21.2 Enteral nutrition | 0 | 0 | Risk Difference (M‐H, Fixed, 95% CI) | 0.0 [0.0, 0.0] |
| 21.3 Supplements | 2 | 305 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.03 [‐0.09, 0.04] |
| 22 HCC ‐ standard amino acids | 0 | 0 | Risk Difference (M‐H, Fixed, 95% CI) | 0.0 [0.0, 0.0] |
| 22.1 Parenteral nutrition | 0 | 0 | Risk Difference (M‐H, Fixed, 95% CI) | 0.0 [0.0, 0.0] |
| 22.2 Enteral nutrition | 0 | 0 | Risk Difference (M‐H, Fixed, 95% CI) | 0.0 [0.0, 0.0] |
| 22.3 Supplements | 0 | 0 | Risk Difference (M‐H, Fixed, 95% CI) | 0.0 [0.0, 0.0] |
| 23 HCC ‐ BCAAs | 2 | 305 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.03 [‐0.09, 0.04] |
| 23.1 Parenteral nutrition | 0 | 0 | Risk Difference (M‐H, Fixed, 95% CI) | 0.0 [0.0, 0.0] |
| 23.2 Enteral nutrition | 0 | 0 | Risk Difference (M‐H, Fixed, 95% CI) | 0.0 [0.0, 0.0] |
| 23.3 Supplements | 2 | 305 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.03 [‐0.09, 0.04] |
| 24 Abstracts excluded | 18 | Risk Difference (M‐H, Fixed, 95% CI) | Subtotals only | |
| 24.1 All trials | 18 | 659 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.02 [‐0.06, 0.02] |
| 24.2 Standard amino acids | 7 | 201 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.01 [‐0.10, 0.08] |
| 24.3 BCAAs | 12 | 471 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.02 [‐0.06, 0.02] |
| 24.4 Parenteral nutrition all | 5 | 231 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.05 [‐0.13, 0.02] |
| 24.5 Parenteral nutrition SAAs | 3 | 87 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.09 [‐0.23, 0.04] |
| 24.6 Parenteral nutrition BCAAs | 2 | 144 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.03 [‐0.12, 0.05] |
| 24.7 Enteral nutrition all | 2 | 48 | Risk Difference (M‐H, Fixed, 95% CI) | 0.14 [‐0.09, 0.37] |
| 24.8 Enteral nutrition SAAs | 2 | 37 | Risk Difference (M‐H, Fixed, 95% CI) | 0.11 [‐0.15, 0.36] |
| 24.9 Enteral nutrition BCAAs | 1 | 24 | Risk Difference (M‐H, Fixed, 95% CI) | 0.21 [‐0.14, 0.56] |
| 24.10 Supplements all | 11 | 380 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.02 [‐0.07, 0.03] |
| 24.11 Supplements ‐ SAAs | 2 | 77 | Risk Difference (M‐H, Fixed, 95% CI) | 0.02 [‐0.11, 0.16] |
| 24.12 Supplements ‐ BCAAs | 9 | 303 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.03 [‐0.08, 0.02] |
| 25 Surgical trials ‐ transplant trials eliminated | 3 | Risk Difference (M‐H, Fixed, 95% CI) | Subtotals only | |
| 25.1 All trials | 3 | 192 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.00 [‐0.07, 0.06] |
| 25.2 Standard amino acids | 0 | 0 | Risk Difference (M‐H, Fixed, 95% CI) | 0.0 [0.0, 0.0] |
| 25.3 BCAAs | 3 | 192 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.00 [‐0.07, 0.06] |
| 26 ITT ‐ Parenteral nutrition ‐ best‐case scenario for intervention | 5 | Risk Difference (M‐H, Fixed, 95% CI) | Subtotals only | |
| 26.1 All trials | 5 | 257 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.16 [‐0.25, ‐0.08] |
| 26.2 Standard amino acids | 3 | 87 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.09 [‐0.23, 0.04] |
| 26.3 BCAAs | 2 | 170 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.2 [‐0.30, ‐0.10] |
| 27 ITT ‐ Parenteral nutrition ‐ worst‐case scenario for intervention | 5 | Risk Difference (M‐H, Fixed, 95% CI) | Subtotals only | |
| 27.1 All trials | 5 | 257 | Risk Difference (M‐H, Fixed, 95% CI) | 0.04 [‐0.04, 0.12] |
| 27.2 Standard amino acids | 3 | 87 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.09 [‐0.23, 0.04] |
| 27.3 BCAAs | 2 | 170 | Risk Difference (M‐H, Fixed, 95% CI) | 0.11 [0.01, 0.20] |
| 28 ITT ‐ Enteral nutrition ‐ best‐case scenario for intervention | 4 | Risk Difference (M‐H, Fixed, 95% CI) | Subtotals only | |
| 28.1 All trials | 4 | 112 | Risk Difference (M‐H, Fixed, 95% CI) | 0.03 [‐0.11, 0.17] |
| 28.2 Standard amino acids | 4 | 101 | Risk Difference (M‐H, Fixed, 95% CI) | 0.01 [‐0.13, 0.16] |
| 28.3 BCAAs | 1 | 24 | Risk Difference (M‐H, Fixed, 95% CI) | 0.21 [‐0.14, 0.56] |
| 29 ITT ‐ Enteral nutrition ‐ worst‐case scenario for intervention | 4 | Risk Difference (M‐H, Fixed, 95% CI) | Subtotals only | |
| 29.1 Standard amino acids | 4 | 112 | Risk Difference (M‐H, Fixed, 95% CI) | 0.21 [0.07, 0.35] |
| 29.2 BCAAs | 1 | 24 | Risk Difference (M‐H, Fixed, 95% CI) | 0.21 [‐0.14, 0.56] |
| 29.3 All trials | 0 | 0 | Risk Difference (M‐H, Fixed, 95% CI) | 0.0 [0.0, 0.0] |
| 30 ITT‐ Supplements ‐ best‐case scenario for intervention | 14 | Risk Difference (M‐H, Fixed, 95% CI) | Subtotals only | |
| 30.1 All trials | 14 | 782 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.08 [‐0.12, ‐0.03] |
| 30.2 Standard amino acids ‐medical trials | 4 | 191 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.15 [‐0.25, ‐0.06] |
| 30.3 BCAAs ‐ medical trials | 10 | 559 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.06 [‐0.11, ‐0.02] |
| 30.4 All supplements ‐ medical | 12 | 707 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.08 [‐0.12, ‐0.03] |
| 30.5 All surgical | 2 | 74 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.05 [‐0.16, 0.05] |
| 31 ITT ‐ Supplements ‐ worst‐case scenario for intervention | 14 | Risk Difference (M‐H, Fixed, 95% CI) | Subtotals only | |
| 31.1 All trials | 14 | 781 | Risk Difference (M‐H, Fixed, 95% CI) | 0.03 [‐0.02, 0.07] |
| 31.2 Standard amino acids ‐medical trials | 4 | 191 | Risk Difference (M‐H, Fixed, 95% CI) | 0.07 [‐0.03, 0.16] |
| 31.3 BCAAs ‐ medical trials | 10 | 559 | Risk Difference (M‐H, Fixed, 95% CI) | 0.00 [‐0.05, 0.05] |
| 31.4 All supplements ‐ medical | 12 | 707 | Risk Difference (M‐H, Fixed, 95% CI) | 0.02 [‐0.03, 0.07] |
| 31.5 All surgical | 2 | 74 | Risk Difference (M‐H, Fixed, 95% CI) | 0.11 [‐0.01, 0.23] |