Summary of findings 1. Reactive water surfaces compared with alternating pressure (active) air surfaces for preventing pressure ulcers.
| Reactive water surfaces compared with alternating pressure (active) air surfaces for preventing pressure ulcers | ||||||
| Patient or population: preventing pressure ulcers Setting: acute care setting and intensive care unit Intervention: reactive water surfaces Comparison: alternating pressure (active) air surfaces | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with alternating pressure (active) air surfaces | Risk with reactive water surfaces | |||||
| Proportion of participants developing a new pressure ulcer Follow‐up: median 10 days | Study population | RR 0.83 (0.35 to 1.93) | 358 (2 RCTs) | ⊕⊝⊝⊝ Very lowa,b | It is uncertain if there is any difference between reactive water surfaces and alternating pressure (active) air surfaces in the proportion of participants developing a new pressure ulcer. | |
| 65 per 1,000 | 54 per 1,000 (23 to 125) | |||||
| Time to pressure ulcer incidence | Included studies did not report this outcome. | |||||
| Support surface‐associated patient comfort | Included studies did not report this outcome. | |||||
| All reported adverse events | Included studies did not report this outcome. | |||||
| Health‐related quality of life | Included studies did not report this outcome. | |||||
| Cost effectiveness | Included studies did not report this outcome. | |||||
| *The risk in the intervention group (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 certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect. | ||||||
aDowngraded twice for high risk of detection bias in 1 study contributing over 60% weight in the meta‐analysis and unclear overall risk of bias in another study. bDowngraded twice for substantial imprecision as the optimal information size (OIS) was not met and the very wide confidence interval crossed RR = 0.75 and 1.25.