for the main comparison.
G‐CSF compared with antibiotics for the prevention of infections and improvement of survival in cancer patients receiving myelotoxic chemotherapy | ||||||
Patient or population: cancer patients receiving myelotoxic chemotherapy Intervention: G‐CSF Comparison: antibiotics | ||||||
Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
Assumed risk | Corresponding risk | |||||
Antibiotics | G‐CSF | |||||
All cause mortality | see comment | not reported | ||||
Infection‐related mortality | see comment | 40 (1 RCT) |
⊕⊝⊝⊝1,2 very low | no patient died of infectious causes during the 18‐week duration of the trial | ||
Quality of life | see comment | not reported | ||||
Incidence of febrile neutropenia | 318 per 1000 |
388 per 1000 (169 to 904) |
RR 1.22 (0.53 to 2.84) |
40 (1 RCT) |
⊕⊝⊝⊝1,2 very low | |
Incidence of severe infections | see comment | not reported | ||||
Adverse events | see comment | not reported | ||||
*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (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). 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. |
1 due to the low number of very low number of events, the result is highly imprecise (downgraded by 2 points)
2 high risk of performance bias (neither patients nor physicians blinded) and detection bias (no intention to treat analysis) (downgraded by 1 point)