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. 2020 Aug 5;2020(8):CD012977. doi: 10.1002/14651858.CD012977.pub2

7. Length of stay measures.

Intervention/Comparison Outcome Results: treatment effect (95% CI) Number of participants (studies) Certainty of the evidence (GRADE) Comments: overview authors' assessment of the certainty of evidence
ED treatment time
Continuous vs intermittent nebulisation: moderate to severe (Camargo 2003) ED treatment time (units not specified) MD ‐1.00 (‐13.50 to 11.50) 70 (1) Low Certainty downgraded due to serious imprecision and serious risk of bias of the single study: unclear sequence generation, no allocation concealment (single‐blind study)
IV magnesium sulfate (Griffiths 2016) ED treatment time (minutes) MD 5.00 (‐24.40 to 34.40) 27 (1) Moderate Certainty downgraded due to serious imprecision
Hospital length of stay
Antibiotics vs placebo (Normansell 2018) Length of hospital stay (days) MD ‐0.10 (‐0.53 to 0.33) 43 (1) Very low Certainty downgraded due to serious imprecision, risk of bias in single study (before good reporting standards introduced: 6 participants excluded but unclear from which arm they were excluded), indirectness (all children with status asthmaticus and study conducted before current asthma management had been introduced (e.g. they all received IV adrenaline)
Addition of IV SABA to inhaled SABA (Travers 2012a) PICU length of stay (hours) MD ‐12.95 (‐38.74 to 12.84) 46 (1) Moderate Certainty downgraded due to serious imprecision
Inhaled anticholinergics + SABA vs SABA alone for children hospitalised with asthma (Vezina 2014) Duration of hospital stay (hours) MD ‐0.28 (‐5.07 to 4.52) 327 (3) Low Certainty downgraded due to risk of bias in review (single author selected possible citations) and serious imprecision
IV aminophylline + SABA + systemic steroids vs placebo + SABA + systemic steroids (Mitra 2005) Length of hospital stay (hours): all patients MD ‐2.1 (‐9.45 to 5.25) 231 (3) Low Certainty downgraded due to risk of bias in review (single author reviewed each abstract) and serious imprecision
Length of hospital stay (hours): submaximal inhaled beta2‐agonists 
(< 45 mg/kg/h) MD 6.00 (‐20.49 to 32.49) 26 (1) Very low Certainty downgraded due to risk of bias in review (single author reviewed each abstract) and very serious imprecision
Length of hospital stay (hours): maximised inhaled beta2‐agonists (≥ 45 mg/kg/h) MD 4.10 (‐13.73 to 21.93) 42 (1) Low Certainty downgraded due to risk of bias in review (single author reviewed each abstract) and serious imprecision
Length of hospital stay (hours): maximised inhaled beta2‐agonists (≥ 45 mg/kg/h) and anticholinergics MD ‐4.32 (‐12.79 to 4.15) 163 (1) Low Certainty downgraded due to risk of bias in review (single author reviewed each abstract) and serious imprecision
IV SABA vs intravenous aminophylline for acute asthma (Travers 2012b) Length of stay (hours): all patients (positive values favour aminophylline) MD 23.19 (‐2.40 to 48.77) 73 (2) Low Certainty downgraded due to very serious imprecision
Length of stay (hours): paediatric (non‐PICU) patients (positive values favour aminophylline) MD 28.10 (‐2.60 to 58.80) 44 (1) Low Certainty downgraded due to very serious imprecision
Length of stay (hours): PICU patients
(positive values favour aminophylline)
MD 12.00 (‐34.31 to 58.31) 29 (1) Low Certainty downgraded due to very serious imprecision
IV magnesium sulfate (Griffiths 2016) Hospital length of stay (hours) MD ‐5.30 (‐9.46 to ‐1.14) 47 (1) High  

CI: confidence interval; GRADE: Grading of Recommendations Assessment, Development and Evaluation; ED: emergency department; IV: intravenous; MD: mean difference; PICU: paediatric intensive care unit: SABA: short‐acting beta2‐agonist; SMD: standardised mean difference.