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. 2020 Feb 27;2020(2):CD011024. doi: 10.1002/14651858.CD011024.pub2

Summary of findings for the main comparison. Audiovisual distraction compared to conventional treatment for increasing acceptance of local anaesthetic in children and adolescents having dental treatment.

Audiovisual distraction compared to conventional treatment for increasing acceptance of LA in children and adolescents having dental treatment
Patient or population: children and adolescents having dental treatment
 Setting: dental clinic
 Intervention: audiovisual distraction
 Comparison: conventional treatment
Outcomes Anticipated absolute effects* (95% CI) Relative effect
 (95% CI) Number of participants
 (studies) Certainty of the evidence
 (GRADE) What this means
Risk with conventional treatment Risk with audiovisual distraction
Acceptance of LA Included studies did not report on this outcome
Completion of dental treatment Included studies did not report on this outcome
Successful LA/painless treatment Included studies did not report on this outcome
Self‐ or observational assessment of intraoperative distress/pain/acceptance of treatment during provision of LA:
pain‐related behaviour during LA
(children who exhibited a negative versus positive behaviour; Frankl Behaviour Rating Scale (FBRS))
Study population RR 0.13
 (0.03 to 0.50) 60
 (1 RCT) ⊕⊝⊝⊝
 VERY LOWa Evidence is uncertain regarding the effect of audiovisual distraction on negative behaviour
533 per 1000 69 per 1000
 (16 to 267)
Patient satisfaction: measured by questionnaires Included studies did not report on this outcome
Adverse effects Included studies did not report on this outcome
*The risk in the intervention group (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; LA: local anaesthetic; MD: mean difference; RCT: randomised controlled trial; RR: risk ratio; VR: virtual reality
GRADE Working Group grades of evidenceHigh 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

aCertainty of the evidence downgraded by 1 level for high risk of bias, and 2 levels for very serious imprecision (single study with a small sample size).