Summary of findings 2. Intermittent ICS versus placebo for preschool children with wheeze.
| Intermittent ICS versus placebo for preschool children with wheeze | ||||||
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Patient or population: Preschool children
Settings: Community
Intervention: Intermittent ICS Control: Placebo | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Exacerbations requiring oral corticosteroids Follow‐up: 12‐52 weeks | 434 per 1000 | 269 per 1000 (192 to 359) | OR 0.48 (0.31 to 0.73) | 490 (4 studies) | ⊕⊕⊕⊝ moderate1 | |
| Serious adverse events Follow‐up: 3 to 12 months | 82 per 1000 | 36 per 1000 (15 to 83) | OR 0.42 (0.17 to 1.02) | 439 (3 studies) | ⊕⊕⊝⊝ low1,2 | |
| Hospitalisations Follow‐up: 6 to 12 months | 149 per 1000 | 113 per 1000 (39 to 286) | OR 0.73 (0.23 to 2.29) | 327 (3 studies) | ⊕⊝⊝⊝ very low1,2,3 | |
| Quality of Life PedsQL total score Follow‐up: mean 12 months | The mean quality of life in the intervention groups was 3.28 higher (‐2.13 to 8.69 higher) | 143 (1 study) | ⊕⊕⊝⊝ low3,4 | |||
| Day time asthma score Standardised mean difference Follow‐up: 12‐52 weeks | The mean daytime asthma score in the intervention groups was 0.35 standard deviations lower (0.57 to 0.13 lower) | 364 (3 studies) | ⊕⊕⊕⊝ moderate1 | SMD ‐0.35 (‐0.57 to ‐0.13); where higher symptom scores indicate worse symptoms | ||
| Night time asthma score Standardised mean difference Follow‐up: 12‐52 weeks | The mean nighttime asthma score in the intervention groups was 0.28 standard deviations lower (0.50 to 0.06 lower) | 364 (3 studies) | ⊕⊕⊕⊝ moderate1 | SMD ‐0.28 (‐0.50 to ‐0.06); where higher symptom scores indicate worse symptoms | ||
| Adverse events Follow‐up: 6 months | 304 per 1000 | 273 per 1000 (155 to 433) | OR 0.86 (0.42 to 1.75) | 166 (1 studies) | ⊕⊕⊝⊝ low2,4 | |
| *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; OR: Odds 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 The included studies vary significantly in their inclusion criteria and risk factors for developing asthma. 2 There were very few events leading to wide confidence intervals.
3 The confidence interval crosses no difference and does not rule out a small increase.
4 This is based on the results of only one study.