Table 4.
Quality appraisal and summary of the systematic reviews/meta-analyses (n = 10)
|
Author (Country) |
PRISMA score (max 27) |
Heterogeneity |
Risk of bias |
Quality assessment instrument |
Number of RCTs & subjects; outcome measure |
Included meta-analysis |
|
Gu et al. 201216 (China) |
24 |
I2 = 61.1% |
Unclear risk of bias |
Jadad scale
CHBa |
4 RCTs, 828 subjects; toothbrushing, prevention of VAP |
Yes
|
|
Hua et al. 201617 (UK) Cochrane |
25 |
I2 = varies with different comparisons |
Low-quality evidence |
CHBa |
38 RCTs, 6016 subjects; oral health care & incidence of VAP |
Yes |
|
Kaneoka et al. 201518 (US) |
22.5 |
I2 = 0% |
High risk of bias |
CHBa |
5 RCTs, 1009 subjects; oral care in preventing pneumonia in non-ventilated patients |
Yes |
|
Klompas et al. 201419 (US) |
23 |
I2 = 0% for cardiac surgeries I2 = 42% for non-cardiac surgery studies |
11 of 16 studies were high quality |
Assessed random sequence generation & allocation concealment only |
16 RCTs, 3630 subjects; CHX & incidence of VAP; compared cardiovascular surgery patient outcomes with non-cardiovascular surgery patient outcomes |
Yes |
|
Labeau et al. 201120 (Belgium) |
23 |
I2 = 29% for CHX; 67% for Povi-Iod |
Not reported |
Checklist from Dutch Cochrane |
14 RCTs, 2481 subjects; oral antiseptics & prevention of VAP |
Yes |
|
Li et al. 201521 (China)
|
23 |
I2 = 49.7% for CHX; 54.8% for Povi-Iod |
Begg's test revealed no publication bias; Jadad score 4 (high quality) |
Jadad scale
|
17 RCTs, 4249 subjects; oral antiseptics & prevention of VAP |
Yes |
|
Liu et al. 201822(China) Cochrane |
24 |
Cochrane's Q and I2 = 67%
|
Low to very low quality evidence
All studies identified as high risk of bias |
CHBa |
4 RCTs, 3905/3546 subjects; oral care & incidence of nursing home acquired pneumonia |
Yes |
|
Sjögren et al. 200823 (Sweden) |
17 |
No MA due to heterogeneity of study designs |
Jadad scores between 3 and 5 for 3 of the RCTs |
Jadad scale |
15, of which only 5 studied interventions; 10 were non-RCT |
No |
|
Shi et al. 201324 (China) Cochrane |
24.5 |
Chi2 and I2 |
High = 17, Low = 5, Unclear = 13 |
CHBa |
35 RCTs, 5374 subjects; oral care & prevention of VAP in ICUs |
Yes |
|
Villar et al. 201625 (Brazil) |
25 |
I2 = 45% |
High = 8, Low = 1, Unclear = 4 |
CHBa |
13 RCTs, 1640 subjects; incidence of VAP |
Yes |
aCHB (Cochrane Handbook for Systematic Reviews of Interventions)