Summary of findings 2. Animal‐assisted therapy (AAT (live animal)) compared to robotic animals for dementia.
| AAT (live animal) compared to robotic animals for dementia | ||||||
| Patient or population: dementia Setting: nursing home or assisted‐living facilities Intervention: AAT (live animal) Comparison: robotic animals | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with robotic animals | Risk with AAT (live animal) | |||||
| Affect and emotional well‐being: depression | — | — | — | — | — | No studies assessed this outcome. |
| Social functioning: duration of physical contact | The median duration of physical contact was 28 seconds | The difference in median duration of physical contact was 65 seconds longer | — | 68 (1 RCT) | ⊕⊕⊝⊝ Lowa,b | Study presented the outcome data in median and interquartile ranges. |
| Social functioning: duration of talk directed at a person | The median duration of talk directed at a person was 206 seconds | The difference in median duration of talk directed at a person was 42 seconds shorter | — | 68 (1 RCT) | ⊕⊕⊝⊝ Lowa,b | Study presented the outcome data in median and interquartile ranges. |
| Social functioning: duration of talk in total | The median duration of talk in total was 307 seconds | The difference in median duration of talk in total was 44 seconds shorter | — | 68 (1 RCT) | ⊕⊕⊝⊝ Lowa,b | Study presented the outcome data in median and interquartile ranges. |
| Behaviour measured using NPI (0–144, higher score indicates more severe neuropsychiatric symptoms) | The mean score using NPI was 29.29 | MD 6.96 lower (14.58 lower to 0.66 higher) | — | 78 (1 RCT) | ⊕⊕⊝⊝ Lowa,c | — |
| Agitation and irritability | — | — | — | — | — | No studies assessed this outcome. |
| Health‐related quality of life measured using QUALID (12–45, higher score indicates poorer quality of life) | The mean quality of life score, measured using QUALID was 26.75 | MD 2.42 lower (5.71 lower to 0.87 higher) | — | 78 (1 RCT) | ⊕⊕⊝⊝ Lowa,c | — |
| Adverse events | — | — | — | — | — | No studies assessed this outcome. |
| Physical functioning: activities of daily living | — | — | — | — | — | No studies assessed this outcome. |
| *The risk in the intervention group (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). The assumed risk in the comparison group is taken from the total event rate (dichotomous outcome) or the range of mean scores (continuous outcome) in the comparison group of the included studies. AAT: animal‐assisted therapy; CI: confidence interval; MD: mean difference; NPI: Neuropsychiatric Inventory; QUALID: Quality of Life in Dementia; RCT: randomised controlled trial. | ||||||
| GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: 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 certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | ||||||
aDowngraded one level. The single included study had unclear risk of bias in allocation concealment and high risk of bias in blinding of participants and personnel. bDowngraded one level. The study had a small sample with an imprecise estimate as reflected by wide interquartile ranges for all outcomes reported. cDowngraded one level. The 95% CI ranged from a substantial lower score (reflecting meaningful benefit) to moderately higher (reflecting meaningful harm), which is very likely to translate into different decisions should either of them have been shown as the true effect.