for the main comparison.

ACTH 4‐9 compared with placebo for children with intractable seizures
Patient or population: children with intractable seizures Settings: Sweden Intervention: ACTH 4‐9 Comparison: placebo
Outcomes	No of Participants (studies)	Quality of the evidence (GRADE)	Comments
Seizure frequency: Two out of five children had some improvement in seizure frequency. One child has unchanged seizure frequency and one child withdrew from the study and other had Infantile spasm.	3 (1)	⊕⊕⊝⊝ low	In spite of a reasonably good study design, there were only three children included in the analysis of this study and a very short follow‐up assessment. Therefore, the study is unlikely to be adequately powered to detect significant differences in treatment groups.
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.