Summary of findings for the main comparison. Nocturnal ventilation versus no ventilation for chronic hypoventilation in patients with neuromuscular and chest wall disorders.
| Nocturnal ventilation versus no ventilation for chronic hypoventilation in patients with neuromuscular and chest wall disorders | ||||||
| Patient or population: patients with neuromuscular and chest wall disorders and chronic hypoventilation Settings: ambulatory patients Intervention: nocturnal ventilation versus no ventilation | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| No ventilation | Nocturnal ventilation | |||||
| Mortality at 1 year (or more) | Study population | RR 0.62 (0.42 to 0.91) | 99 (4 studies) | ⊕⊝⊝⊝ very low1,2 | ||
| 521 per 1000 | 323 per 1000 (219 to 474) | |||||
| Moderate | ||||||
| 421 per 1000 | 261 per 1000 (177 to 383) | |||||
| Unplanned admission to hospital | Study population | RR 0.25 (0.08 to 0.82) | 38 (2 studies) | ⊕⊝⊝⊝ very low1,2 | ||
| 526 per 1000 | 132 per 1000 (42 to 432) | |||||
| Moderate | ||||||
| 517 per 1000 | 129 per 1000 (41 to 424) | |||||
| No improvement of hypoventilation symptoms: long‐term | Study population | RR 0.43 (0.18 to 1.03) | 51 (3 studies) | ⊕⊝⊝⊝ very low1,2 | ||
| 885 per 1000 | 380 per 1000 (159 to 911) | |||||
| Moderate | ||||||
| 900 per 1000 | 387 per 1000 (162 to 927) | |||||
| No improvement of daytime hypercapnia: long‐term | Study population | RR 0.59 (0.41 to 0.86) | 58 (3 studies) | ⊕⊝⊝⊝ very low1,2 | ||
| 828 per 1000 | 488 per 1000 (339 to 712) | |||||
| Moderate | ||||||
| 778 per 1000 | 459 per 1000 (319 to 669) | |||||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in a footnote3. The corresponding risk (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; 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. | ||||||
1Small unblinded trials. 2There was strong heterogeneity across the trials, possibly related to populations with very different severity of illness. 3Assumed control risk is based on actual control group risk as reported in included trials.